680324.pdfBUILDING DEPARTMENT Appumutm
PERMIT APPLICATION Inade 'Reavy 'men
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Property (show Below or Attach Foll
KROLL AL4P NO.. I PERMIT
6-9
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PCIS'PING STREET R/w4.Q./*4A-
COMP. PLAN ST. R/W".&.FT-
NUMBER bOUJ4%a
;ACK RZAR YARD BETP�ACXX
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�C:
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VAC"w aLwm
rl E 40
ile E3 YES 9.No
1111VICIENCT THIS PROPERTY
indicated on Standard Drawing #1030
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YES 000
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SPECIAL INSPECTOR
13 YES 0
or
Occ cup
ErNE1W
ElRETAINING
ALTER
REPAIR
I ErREIIII)ENTIAL
I El
NON-RESMENTIALJ
DEMOLIE
EXCAVATE
on FILL
PRE -MOVE
INSP. El
a
=19
SIGN
WAML
FENCE
( ........ x .......... rt.)
SWIM
POOL
PLAN CHECKED
P5
REMARKW
Nis, 51 xid9nwd
60t back 'a effect at time
C U was approved.
City Attorney 01tatsel tb&t
4. Seale
this ShOVIA tags-41.
0
A* Ellin
ES
NUMBER OF
DWELLING
UNITS
Plan Check No ... I ... k. k-
PROPOSED UBE
BUILDING
PLUM[BING
PLOT PLAN (Indicate Building setbacks, abutting streets)
BEAT & GAS LINE
PENCE
t
130 1
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin applIcLUon; that the In-
formation given is correct; and that I am the owner, or the duly author-
lZed 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
relating to Workman's Compensation Insurance.
AUTHORIZES
NOTE: Permit imit One Your (Except DEMOLITIONS which
ONLY T=
WORK NOTZD
sh be completed ninety "; MOVED -IN ISULLDINGS shall be cam -
in six monU f)
110 (0 OR OR AGENT) SIGNED
R
INSPECTION
I
DEPARTMENT
(7�
4 4NnO(TO TE:Aphp�"finint
CITY OF
EDMONDS
Subjeet to Plan Cbeck Fee
PR 6-1107
— This PernUt covers work to be done an Private PrOPertY ONLY -
Any eanstruction on the public domain (earla, sidewalkli, driveways,
marquees, do.) will require separate Perm][251011.
Valuation
bi
ra
I a-,> 0 - 50 V#5"i� �
APPLICATION APPROVAL
This application is not a perfnit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
4
I
i
I
20th
Issued this
—day of — March 19_L9_
CHIEF BUILDING OFFICIAL BY `4 w
co"
This certificate shall be posted in a conspicuous public area and shall not be removed, mutilated or obscured and shall be main-
tained In legible condition at all times. Any change of occupancy requires a new certificate.
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