680372.pdfA,
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BUILDING PEPARTMIENT Applicant FM
PERFAIT APPLICATION I inside Heavy lAnes
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If _TEILEPHONE N
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PERMIT
NUMBER680372
IDTIJI—ACIKC STREET SETBAC REAR YARD SETBJ%CK
LOT AIRMEA A 2VACANT SITE
-V13 YES 0
VMj70_M �UER
FW
STREET R/W ........... XT-
LAN ST. R/W ............ FT -
GAS 0 YES 0 NO
1111DIINT: LINE TDCN—CHEC 7
NEW RtON-RE1313 MNTIAL SIGN &�'
ADD I RETAINING REMARVr
DEMOLISH WALL
ALTER EXCAVATE PENCE
OR PILL ( ........ . X... Ft.)
PRE -MOVE SWIM
REPAIR INSP. POOL I
DWELLING
UNITS
Plan Check No ............. ... ...
P
PROPOSED USE
BUILDING
PLOT PLAN (indicate Building setbacks, abutting streets)
PLUXIIING
02
HEAT & GAS LINE
PENCE
t
SIGN
, RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
DEFICIENCY THIS PROPERTY
YES C3 NO
Fee
I
TOTAL AMOUNT DUE
I hereby acknowledge Mat I have read this application; that the in-
formation given Is correct; and that I am the owner, or the duly author-
I agree to comply with city and state laws r6gu"
ATTENTION
A'
APPLICATION APPROVAL
Ized agent of the owner.
lating construction; &M in doing the work authorized thereby, no person
of the Labor Code of the Slats Of Washington
THIS PERMIT
This application is not a perntit until
will be employed In violation
relating to Work1n6n,s Compensation Insurance.
AUTHORIZES
A
signed by the Building Official or bis Dep-
NOTE: permit umit one Your (Except DEDIOLITION8 which
rA ONLY THE
WORK NOTED
M
uty; and fees are paid, and receipt is ac-
shall be complebed-An ninety days; MOVED -IN BUILDINGS @hall be oom.
knowledged in space pr ovided.
pleted Irk six months.)
4ra 'Anww-ril DATE SICF314PD
-Up: OR AGENT)
INSPECTION
DIRECTOR'S all I URE
114,1114,111
DEPARTMENT
IAA-
CITY OF
D!ATq
EDMONDS
NOTE: APPficanrSubject to Plan Cbeck Fee
PH 6-1107
his permIt covers work to be done on private PrOPOrty ONLY -
PTLJC
Any construction On the pubile domain (ewbst sidewalkel driveways,
marquees, etc.) will require separate permission.
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