680332.pdfInsIde Heavy Lines J B ADDRESS
PERMIT APPLICATION
I NAME (OR 2 0) 61 0/
`TBACK STREET IFFA—K Y D SETBACK
SETBACK
IDE YARD BE
G ADDRESS
k". LOT IL VAU"
NO
UMBER
T OrTY a"Cill NUMBER ow
PCI tv on �/_s 503 MG AREA
00-
I ki I
I
NAME PLOT PLAY
_;A? 70V
_V
ADD AM a
ET R/W DEFICIENCY THIS PROPERTY
CITY TIM UMBER COUP. LAN ST. R/W -41RFT. FT.
REMARKS
NAME Dr e n exceed those
ive
indicated on Standard Draw.ing #103.
CHECKED BY
ONE NUMBER
CITY V
ZE ICLEARANCE
? REMARKS
Legal Description Of Property (Scow nalow or Attaca F-our Copies)
TYPE CONNECTION VE
PERO. TEST T%tn
'rER
REMARKS
Septic tank design ok.
I= zo TYPE OF CoNs�VUCTION1 IMPROVED
STREET
[3 YE13 [3 NO
PECTOR REQUIRIED O0CUfAN CUP
0 YES NO
&As
NEW RESIDENTIJ4Z NEI PLAN CHEC71) BY
NON-RESIDENTIAL SIGN
ElADD RETAINING REMARKS
ElDEMOLISH WALL
ALTER EXCAVATE FENCE
OR FILL ( ........ x . ........ rt.)
REPAIR PRE -MOVE SWIM
El INSP. El POOL
b iR OF
DWELLING
UNITS
—WA—TUR30 OF WORK TO BE DONE
Valuation Fee Receipt No.
Plan Check
PROPOSED UBE BUILDING
PLOT PLAN (Indicate Building utting at PLUMBING
HEAT & GA13 LINE
PENCE
t SIGN
�5 /71 REiTAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPEC'TION
EXCAVATION OR FILL
TOTAL AMOUNT DUE 110-Z 0
I hereby acknowledge that I have read this application; that the In-
formation given In correct; and that I am the owner, or the duly author -
lead agent of the owner. I agree to comply with city and state laws regu- ATMZMON APPLICATION APPROVAL
laUnff construction; and In doing the work authorized thereby, no person
will be employed In violation Of the Labor Code of the State Of Washington TIM PERMIT This application is not a permit until
relating to WorkmeWm COMPeDALUOU I"Ursuca- AUTHORIZES signed by the Building Official or his Dep-
ONLY TIM
NOTE: Permit Limit One Your (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com- knowledged in space providLA
plated In six Months.)
—DATE SIONEI) INSPECTION
SIGN WNER 70ENT) DEPARTMENT
L/
.Z . . 1
2 &V M CITY OF DATE
EDMONDS
NOTE: Applicont Subject to Plan Check Fee PR 6-1107
him permit coven work to be done an private property ONLY.
Any oondruction an the pubUe domain (curbs, sidewalks, drIveways, rum
marquees, a".) win require separate PGrn1d5&IOO-