670391.pdf............
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PERMIT
POSTED ON KROLL MAP NO.:
NUMBER b 70,391
,.:.BUILDING DEPARTMENT Applicant Fill
r,7,,,7 Inside Heavy Lines joB ADDRESS
PERMIT APPLICATION
I NAMM (OR NAM OF BUSINESS)
I
0
or
2_,_7
2—.,'
DNEW
RESIDFNTIAL JEJ
GAS
LINE
NON-RESIDENTIAL
F-1
SIGN
ElADD
RETAINING
ElDEMOLISH
D
WALL
ALTER
EXCAVATE
OR FILL
PENCE
�.74 ... X./ .... Ft.)
D REPAIR
PRE -MOVE
INSP.
SWIM
POOL
iUMBER OF STORIES
I NUMBER OF
DWELIANG
UNITS
0 YES
13 NO
NG STREET R/W ............ FT- DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT- ........... 1".
[3 YES [3 NO
D
rian Check No .....................
El, PROPOSED USE
BUILDING
PLOT PLAN (Indicate Building setbacks, abutting streets)
PLUMBING
HEAT & GAS LINE
PENCE
t
SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I bereby acknowledge that I have read this application; that the In-
formation given is correct; and that I am the owner, or the duly author-
ized 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
relating to Workman's CompenAILU011 Insurance.
NOTE: Permit Limit One Year (Except DE31OLITIONS which
ATTENTION
THIS PEILMIT
AUTHORIZES
ONLY THE
WORK NOTED
shall be completed In ninety days; BIOVED-IN BUILDINGS shall be com-
pleted in six months.)
INSPECTION
DEPARTMENT
CITY OF
SIGNATURE (OWNER OR AGENT) TA-TESIGNED
y ILI-
EDMONDS
INOTE: Applicant Subject to Plan Check Fee
PR B-1107
This Permit covers work to be done on privatO Property UNAlk-
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require sepamte permission.
()a
[] YES [:] NO
Fee
No.
I a - 0 0 13 171�1
APPLICATION APPROVAL
This application is not a pern-at until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
f U-7 I
FILE