680112.pdfBUILDING DEPARTMENT
U
PERMIT
P E'
APPLICATION
HAMS
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NAME
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ADDA EBB
Applicant M
Inside Heavy lAnes
G
PERMIT
ran=MR, 680
YES 13 NO
EXISTING STREET R/W DEFICIENCY THIS PROPERTY
I
REMARKS
COUP. PLAN ST. R/W ...... ..... FT.
NAME
CHECKED 13T
y
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_WL�EPHONENUMBM
METER
SIZE SERVICE SIZE
CLEML&NCE
CHECKED BY
UMBER
'4z 0, 0
CITY lAmMula NUMBER
REMARES
'JAgal Dreacription of Property (Show M-0war—AU&C12 Four Copies)
TYPE
CONNECT ON
VERIFIED BY
PERC.
TEST
PERMIT NUMBER
REMARKS
ZONE TYPE OF CONSTRUCTION STREW IMPROVED
[3 YES E3 NO
FIRE
SPECIAL
INSPECTOR REQUIRED
I OCCUPANCY GROUP
RESIDENTIAL
GAS
LINE
NEW
[=
NON-R ESIDENTAL
SIGN
E] �w
RETAINING
WALL
DEMOLISH
A LT"n
0
EXCAVATE
on rim
FENCE
( x Irt.)
........ . ..........
REPAIR
1:1
PRE -MOVE
INSP.
swim
POOL
ES
NUMBER OF
DWELLING
UNITS
fATURE OF WORK TO BE DONE
t
N
I
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 author -
iced agent of the owner. I agree to Comply With city and state laws regu-
iating construction; and in doing the work authorized thereby. no perxon
will be employed in violation of the Labor Code of the State of Washington
relating to WorkmeWs Compensation Insurance.
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be oom-
pleted in s)X months.)
YES C3 NO
rian Check No .....................
1;1"o _03RIffl
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
400UZI/ 'o,:7 /,< 4&_711_1X_11 314? - 2/c/o r I
NOTE: Applicant Subject to An Check Fee
This Permit covers work to be dous on pr[vMs PrOPWtY ONLY.
Any eampgruenon on the public domain (curb@, sidewalks, driveways,
co"quees, atc.) wui require separate permission.
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PE 6-1107
Valuation
L-1
Fee
w4pno
APPLICATION APPROVAL
No.
This application is not a pernilt until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
linowledged in space provided.
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RECORD OF INSPEMONS
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Date Passed
Ilv .1ro
Foundation r "I I�
I- L N I
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X I
ng (Parflaily
Plumbl
(Rough)
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Furnace & Fuel Line
Final
IT
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RECORD OF INSPECTION e
Date Passeo 1;
Drainage
Sewer
Parking
I . Landscaping
ire Depta
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