680114.pdfI
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POSTED ON ROIJ- MAP NO-: PERMIT 6801 14
PARTMINT Applicant Fill NUMBER
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LICATIONInside Heavy Lines JOB ADDRESS --CIO
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R IIET13AIC
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US)LkONE LOT A.REA VAC SITE
NO
M
ZLEPHO TE JNUMBXR YE
—VVARIANCE NUMBER
HEIGHT ffUfLDING_ AREA
7 H
PLOT PLAN APPROVED
or
r
RESIDENTIAL
GAS
LINE
NEW
ALTER
NON-RESIDENTIAL
SIGN
RETAINING
WALL
PENCE
( ......... x .......... Ft.)
DEMOLISH
EXCAVATE
OR FILL
REPAIR
PRE -MOVE
INSP.
swim
POOL
[UMBER OF STORIES
I NUMBER OF
DWELLING
UNITS
____ —1 ..
EXISTING STREET R/W ............ FT- DEFICIENCY THIS PROPERTY
comp. PLAN ST. R/W ............ FT.
[I YES [3 NO
plan Check No .....................
PROPOSED USE BUILDING
PLOT PLAN (Indicate Buildini; setbacks, abutting streets) PLUMBING
HEAT & GAS LINE
PENCE
t SIGN
RETAINING WALL
N% It
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
NJ TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin 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- ATTENTION
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
fainting to Workman'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-
plated in six months.) INSPECTION
,iER OR I DATE 81 NED
W
DEPARTMENT
CITY OF
EDMONDS
NOTE: A4icant Subject to Plan Check- Fee PR 6-IL107
This permit coven work to be done on private property ONLY.
Amy construction on the public domain (curbs, aldewalks, driveways,
marqueas, etc.) will require separate permission.
[] YES (3 No
Fee I Receipt No.
1 :3. 0 D 1(1+3 toC
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-
Imowledged In space provided.
-Cap_ -