680165.pdfPOSTED ON KROLL MAP NO PERMIT
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BUILDING DEPARTMENT
Applicant Fill
/ 1�1;1 1 0 �� I NUMBER
PERMIT APPLICATION
inside Heavy Lines
jOB ADDItEsS
NAME (OR NAME O"USINEBB)
4
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-rID—LYARD SET STREET SETBACK
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ArAILING ADDRESS
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CITY
TELEPHONE
HEIGHT AUNA
v , ARIANCEI NUMUNIC
FL—OT-PLAN APPROVED
ADDRESS
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1Z 2 0 76 7�4 St -
STREET R/ V
31TREET rt/w.&P.xr. DEFICIENCY THIS PROPERTY
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COUP. PLAN ST. R/WV"
REMARKS
NAM
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ADDRESS
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13 LICENSE, NUMBER C
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Description of Property (kinow Aselow ;-r
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110 /
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2/N�l
2--RESIDENTI
GA13
LINE
NTIAL
R
SIGN
ADD
RETAINING
WALL
DEMOLISH
DALTER
EXCAVATE
FENCE
OR FILL
( ........ . x .......... Ft.)
REPAIR
PRE;�OVM
INS
swim
POOL
DWELLING
UNITS
FIRE
MA
[3 YES [3 NO
0 YES 0140
REMARKS
shop drawings of Aden Pre -Cast StOP8 will__
be submitted to this office before frabicati o
Plan che 1-1#-17
ck N
PROPOSED USE
BUILDING
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets)
BEAT &GAS LINE &
PENCE
15
SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
NPRE
-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge th&# 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-
AT=NTION
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of WeAhington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORH NOTED
shall be completed in ninety day$; MOVED -IN BUILDINGS shall be eom-
pleted In six months.)
Iy_ (OWNElt OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
3 Z�— C-<f-
I
CITY OF
EDDIONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
TbIs'permit covers work to be done an private property ONLY.
Any construction on the public domain (curbs. sidewalks, driveways,
marquees, etc.) will require separate permission.
I eo
Fee Receipt No.
7`1
� .75-t 4-�
�Mol
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-
lmowledged in space provided.
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rum
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9
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4;. �
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RECORD OF INSPECTIONS
Date,Passed
Founda
tion s
Plumbing (Partial)
(Rough) V
Frame &1, - ZAAA1,
Furnace & Fuel Lines
Final
ReeoRD OF INSPECTIONS
�Date Passed
Drainage
Sewer
Parking
Landscaping%
L—��Fire Dept.