670352.pdfUILDING DEPARTMEN
PERMIT APPLICATION
■ Al L
� rt • 1
1 1
iLi0AN8
— //) !:5' //
�O mil' Av
BIDENTIAL CLINE
NEW
NON-RESIDENTIAL SIGN
CI ADD RETAINING
DEMOLISH �LTER EXCAVATE OR FILL � PENCE
N a_........H't.)
REPAIR SP, SWIL
NUMBER OF STORIES NUMBER OF
DWELLING
2 UNITS ON 1�0
NO.
RZOAM
D
REAR YARD SETBACK
�- O f l �l iw.J d
VAOANT SITIO
YES 17 NO
VARIANCE NUMBER
r
i
EXISTING STREET
R/W
,.......... FT,
DEFICIENCY THIS PROPERTY
COMP. PLAN ST.
R/W
............FT,
I ....
Plan Check No, ........... _.......
PROPOSED USE
BUILDING
PLOT PLAN (Indicate Building setbacks, abutting streets) PLUMBING
HEAT h GAS LINE
FENCE
S OUnin %ram t SIGN
RETAINING WALL
SWIMMING POOL
/ji2AOD(,J pq� DEMOLITION
BAt/y �P.
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given to correct; and that I am the owner, or the duly author-
lzed agent of the owner. I agree to comply with city and state laws regu-
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington THIS PERMIT
relating to Workmen's Compensation Insurance, AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
lIGN RE (OWNER O A ENT DATE SIGNED INSPECTION
DEPARTMENT
(O CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will reVuire separate permission,
Valuation
S S,
N*A jzj
Fee
EE
No,
3-oo I3gi4i
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided,
I
FILE
...',•YI , t ,. r 1 F ? ,:� �i•: a r i11E'u, r.
s'
F fk. It
4
nrkL.
..�
.. i
t it
ay
n
Ilt
It
e
,?
,t I
,
,t
°1 p`tt
i
1 fi V
t d
,
r
n i01
r +,
tp
It
5'
! � , Ll
Y.i
i.
40
t
i 2
a.. �. •r.. l• ,
e ..... t,
-
RECORD OF,INSPEC710NS `.
r <
t Date Passed ""
�.
Foundation .
Plumbing (Partial)
1-4
(Rough) .�-�'It
f Frame =_
Furnace & Fuel Une' f
--�•
Final �Z
:_. .J:.. ... _. .. .,.i.. ..t'� .t.l'Jk rF,r s 1.Aa, taut i, w,t.
.. :. l r ' i''r t..
ffit 14 rr,a 1 A t
i
...u... Lam - ., _I I k I - .
4..... ♦ ...