680052.pdfood & Robert
Was
- 3rd Avenue
le. Wash.
Applicant Fill
inside Heavy Lines
Inc.
MA 2-9141
I of Lot 5, LESS the N 501
�iereof;,TOGETHER WITH the W 65' o
at 6; all in jOHNSON GARDEN TRACT
acording to the plat thereof recc
d tLL V01ULUe ±6 of PlfttS2 en Page
ecords of Snohomish County, Wash.
NEW
RESIDENTIAL
NON-RESIDENTIAL
ADD
DEMOLISH
EALTER
0
EXCAVATE
OR FILL
REPAIR
M.
PRE -MOVE
INSP.
GAS
LINE
0
AIGN
RETAINING
WALL
PENCE
( ........ x . ....... Ft.)
SWIM
POOL
one IDWELLING
UNITS one
EXISTING STREET R/W ........... PT -
COUP. PLAN ST. R/W ............ Fr.
PERMIT
NUMBER
YES
DrXICIENCY THIS PROPER7r
M
YES 1`1 NO
Plan Cheek
BUILDING
PLUMBING
HEAT & GAS LINE
t
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
I
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the in-
formation given IN correct; and that I am the owner, or the duly au..-
Ized agent of the owner, I agree to comply with city and state laws rigu-
toting 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 Workmen -a Compensation Insurance.
NOTE: Permit Urnit One Year (Except DE3101JTIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
plated In six months.)
4 z?
NOTE: Applicant Subject to Plan Check Fee
This Peratit covers work to be done on private Property ONLY.
Any construction an the public domalim (curbs, sidewalks. drlv&wayo,
marquees, etc.) will require separate permission.
[] YES [3 NO
�. �Ora
TOTALAMOUNT DUE L 113. 0 0 L4.1s
ATTENMON I APPLICATION APPROVAL
THIS PERMIT TII]a application is not a permit until
AUTHORIZES
ONLY THE signed by the Building Official or his Dep-
WORK NOTED uty; and fees are paid, and receipt is ac-
I Imowledged in space provided.
INSPECTION D 'a BIG
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
P � b 6
FILE
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