680133.pdfBUILDING DEPARTMENT
PERMIT APPLICATION
NAXIM (OR NAME OJr BUSINESS)
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i;�S:WNG STAEET R/W . ......... FT- 3:)EFfcfENcy THIS PROPERTY
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NUMBER
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CTE LICE—NOE NUMB TY LICENSE NO
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6/ Paylle0317" _fEEMA
gal Description of I-roperty (Show )Below or Attach Four Copies)
6457P/yj CA106 6061-? TYPE
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ElNEW
RESIDENTIAL
GAS
LINE
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PLAN-
.
NON-RESIDENTIAL]
SIGN
REMAJ
ADD �17AINING
DEMOLISH WALL
ALTER
EXCAVATE
OR FILL
FENCE
( .......... x ......... Ft.)
REPAIR
11
PRE -MOVE
INSP.
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POOL
ES
NUMBER uk,
15
DWELLING
UNITS
-WARTURE OF WORK TO BE DONE
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6: (W- 00/v k Plan Check No ............ . .......
PROPOSED USE
BUILDING
PLUMBING A)01-C
Q
22
PLOT PLAN (Indicate Bui d ng setbacks, abutting streets)
HEAT & GAS LINE
FENCE
0
I
SIGN
4*N
1
RETAINING WALL
coo
0'
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
or
I hereby acknowledge that I have read this appltration; 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 Workmen's Compensation Insurance.
NOTE: Permit Umit One Year (Except DEMOLITIONS which
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
shall be completed in ninety days; MOVED -IN BUILDINGS shall be oom-
pleted In six months.) I
INSPECTION
DEPARTMENT
—
SIGNAT (0 IE OR E
DATE IGNE
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check- Fce
PR 6-1107
This ParmIt covers work to be done on PrlVmtc property ONLY -
Any construction ce, the public domain (curbs, sidewalks, driveways.
marquees, etc.) will require separate permI581013.
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go
[] YES [I NO
Valuation I Fee I Receipt No.
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APPLICATION APPROVAL
This application is not a pern-dt until
signed by the Building official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
ett
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DESCRIPTION
D-5B lot 20, Edmonds Seaview
Tracts, Beg. SE cor. Tr 20th N.
0026117", E. a.1S E. In Tr 20
88. 1W� to nxn a In pll with
& 5401 s. of n. In. sd tr th
N. 89044113" W. pll N. In
s tr 150' th S. 0026'17't
d
W. 88.85' to s in of 3D tr th
S. 89047'33" E. aig S. In
1501 to SE cor. tr 20 TPB
less S. 8' thof.
REC IONS
ORD OF INSPECT
Date Passed
Foundation
Plumbing (Partial) X;e -
(Rough)
& j
Frame
Furnace & Fuel Line
a- 5R-Z
Final
OF INSPECTIONS
RE CORD
Date passe
f
'Drainage
Sewer
parWing
Landscaping
Fire Dept.