680351.pdfNORM
BUILDING DEPARTMENT Applicant Fill
Inside Heavy Lines
PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
Wo�-1 - _17. 9/-2/27 At
CITY
NAME
ril _15-D-RESS
CITY
NAM
ADDRESS
CITY
STATE LICENSE NUMBER
Legal Description of Property (Show Below
5 , e 1-4 4 /V. le5qeq lav-
GAS
E] NEW RESIDENTIAL R LINE
NON-RESIDENTIAI, I F� SIGN
ADD RETAINING
0 DEMOLISH WALL
ALTER EXCAVATE FENCE
R OR FILL ( .......... x .......... Ft.)
REPAIR PRE -MOVE swim
1:1 INSP. POOL
IUMBER OF STORIES NUMBER OF
DWELLING
/9VV 4f-- UNITS
�.j
POSTED ON KROLL MAP NO.. PERMIT
680351
NUMBER
JOB ADDRESS (560 �4�
SIDE YARD SETBACK STREET SETBACK
REAR YARD SN'K1jAt;rL
USE ZONn LOT AREA
CANT SITE
Z,
YES [3 NO
H I HT BUILDING AREA
VARIANCE NUMBER
N
PLOT PLAN APPROVED
Alz ("O;a
STREET R/W
EXISTING STREET R/W DEFICIENCY THIS PROPERTY
COUP. PLAN ST. n/w ...... -.-.rr.
REMARKS
TYPE
YES (3 NO
Ig f=_ Plan Check No ............ . .......
PROPOSED UBF
BUILDING
Q
PLOT PLAN (Indicate Building setbacks, abutting streets) PLUMBING
HEAT & GAS LINE
PENCE
t SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that 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. ATTENTION
lating construction; add to 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 Workmen's Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DE11OLITIONS which WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted. In six months.)
INSPECTION
SIGM WNER OR AGENT) DATE BIG 'D
e-1 / DEPARTMENT
7)/
CITY OF
EDMONDS
NOTE: A�Plicant Subject to Plan Check Fcc PR 6-1107
This Permit covers work to be done an private property ONLY.
Any construction on the public donude, (curbs, sldevralks, driveway*,
marquess, etc.) will require separate permission.
0 YES [:] NO
Valuation Fee
0
APPLICATION APPROVAL
Will
I
This application is not a pernift until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged In space provided.
�:1�
FILE
............
- - - - - - .....
:q A I
4
we, RECORD OF WpEnoNg
Date Passed
lFoundation
it
Plumbing (Partial)
(Rough)
pzv
Frame
Furnace & Fuel Lines
Final
RECORD OF INSPECTIONS
Date Passed
Drainage
Sewer
Parking
Landscaping
Fire Dept.