680341.pdfBUILDING DEPARTMENT
PERMIT APPLICATION
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P013TED ON KROLL MAP NO.: PERMIT b8034
Applicant Fill 1 '10 NUMBER
inside Heavy Lines JUB ADDRESS
_91—DE T!Itl) S�E7TIHACK STREET SETBACK REAR YARD 8
0
Ei�t_a
_11—EIART mUILL)INU AREA VARIA
4(l 1 — _ 1E LOT AREA VACANT BITE
XPRONE IWAILSMin YES
/ NCE NU�
I
M
GASRESIDENTIAL
LINE
NEW
El
NON-RESIDENTLILL
SIGN
ADD
RETAINING
WALL
ElDEMOLISH
ALTER
0
EXCAVATE
OR FILL
PENCE
( .......... x .......... Vt.)
REPAIR
R
PRE -MOVE
INSP.
swim
POOL
NUMBER OF
DWELLING
UNITS
F
Al
EXISTING STREET R/W -603"- DEFICIENCY THIS PPROPERTY
r
COMP. PLAN ST. R/W -:5�- b"T.
REMARKS
Driveway slopes not to exc:c:e:ed those
indicated on Standard Drawing 103.
[3 YES
rian Check No ............ . .......
PROPOSED USE
BUILDING
PLOT PLAN �(Indlate Building setbacjw, abutting streets)
PLUMBING
BEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
pRn-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1 hereby ack owledge that I have read this application; that the In-
formation given in 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-
ATTENTION
and In doing the work authorized thereby, no person
lating construction;
will be employed in violation Of the Labor Code of the State of Washington
THIS PERMIT
relating to WorkmeWs Compensation Insurance.
AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which
NVOnK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com.
pleted In six months.)
SIGNATURE (OWNNIf un "e"I" CAT SIGN
INSPECTION
DEPARTMENT
7
OITY OF
EDMONDS
NOTE: Applicant Subject to P14HCheck Fcc
PR 0-1107
This pamdt coven work to be done on private property ONLY.
Any construction on the public domain (curb@, sidewalks. driveways,
marquees, etc.) will require separate permission.
Valuation
[] YES
Fee
,08:5-0
I
to
Ila / , -5-0 1 L45-t-S,
APPLICATION APPROVAL
This application is not a perralt until
signed by the Building official or Ills Dep-
uty; and fees are paid, and receipt is ac-
lmowledged in space provided.
— /_ P9 _�
I
RECORD OF INSPECTIONS
Date Passed
7
Foundation
Plumbing (Partial)
(Rough),
Frame
C- & Fuel Lin
Furnace
Final
RECORD OF INSPECTIONS.
Date Passed,
Drainage
sewer
Parking
and caping
L S
fire Dept. -
5