680225.pdfAiplimsit Via
BUILDING DEPARTMENT
PERMIT APPLICATION' ftddeHeavyL'Re5
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ElNEW
RESIDENTIAL
El
GAS
LINE
NON-RESMENTIAL
SIGN
RETAINING
DEMOLISH
WALL
ALTER
EXCAVATE
OR FILL
PENCE
( x Ft.)
........ ..........
REPAIR
E]
PRE -MOVE
INSP.
SWIM
POOL
t
N
I
I hereby &WOW1094, Mgt I bavO read this application; that the in-
formation given is eon -act; and that I am the owner, or the duty author-
ized agent of the o7mer. I agree to comply with city and state laws regu-
lating construction; old in doing the work authorized thereby, no person
will be employed in violation of As Labor Code of the State of Washington
relating to Worj=gWg Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
gball be completed in ninety days; MOVED -IN HVILDINGS mhall be com-
plated In SIX Months-)
NOTE: APPlicant * Su.bject to Plan Check Fee
This P milt cov private Property ONLY -
Any consixuctlou on the public domain (curbs, sl4awalkst driveways,
marquees, etc.) Will require separate permission -
7tom
EXISTING STREET R/W
COMP. PLAN ST. R/W ........ .. Jff-
13 YES 0 NO
Plan Cheek
PLUMBING W13
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
TWS PERBUT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
rR 6-1107
7�
PERIM
NUMBER
VACANT WITM
E3 YES 0 NO
VARIANCE WU �Eft
DEFICIENCY THIS PROPERTY
Valuation
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or rds Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILM
Date Passed
Remo De L_ Foundation
_40
Plumbing (Partial)
0i'_
1-, '510 ?)�`T R6 _(Rough)
VIJU 'j #Z�'j 0 ':F-, Fmme
Furnace & Fuel Lines--
o.,r
Lq Final
V7 Z 115)
A'I —ULAJ \\J — RECORD OF INSPECTIONS
Date Passed
Drainage
Sewer
Parking
Landscaping
Fire D��pt- --------