680396.pdfUILDING DEPARTMENT
PERMIT APPLICATION
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Applicant Fill
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680396
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:MARKS
Drivew" slopes not to exceed those A
indicated on Standard Drawing #103. 0 1
UMBER
CITY
MET SERVICE SIZE CLEARANCE C
Q STATE LICENSE NUMBER CITY 94
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REMARKS
Legal Description of Property (Show Below or Attach Four Copies)
�&_ U& �K I�zooFt TYPE CONNECTION VERI"DD BY
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7AX, PERC. TEST PERMrY.JUMBER
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REMARKS
Ar- f- 0APAV5 7") 7-111, ol&r. �F_to
V FIRE TYPE OF CONSTRUCTION STREET IMPROVED
'y'-T r 0 YES
UIRED OCCUPANCY GROUP
SPECIAL INSPECTOR
GAS 0 YES
NEW RESIDENTIAL LINE ;P�LAN.0 �ECD. Y
NON.RESIDENT!�j SIGI;
ADD RETAINING REMtr
DEMOLISH El WALL
ALTER EXCAVATE FENCE
F� OR FILL El ( .......... x .......... Ft.)
REPAIR PRE -MOVE swim
El INSP. El POOL
LES NUMBER OF
DWELLING
UNITS
NATURE F WORK TO BE N
AIC /Do Valuation Fee Receipt No.
rian Check No ..................
PROPOBEDF�0 —
BUILDING
-PLOT PLAN (Indicate Building setbacks, abutting streets) PLUMBING
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HEAT & GAS LINE-
F lbao
PENCE
t SIGN
RETAINING WALL
SWIMMING POOL
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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 APPLICATION APPROVAL
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 THISPERMIT This application Is not a permit Until
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY THE Signed by the Building Official or his Dep-
NOTE: Permit Limit one Year (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 eom- knowledged in space provided.
DLRECTOR�ij,
plated In six months.) R AGENT) DATE S)KINED INSPECTION
SIONAT WNE DEPARTMENT
CITY OF DAT
EDMONDS
NOTEf ct to Plan Cbech Fee
: Applicant Subje PR 0.1107
This permit covers work to be done on private property ONLY.
Any constmetton on the public domain (curbs, Bidewalks, driveways. FILE
ma.rquees, etc.) will require separate permission.
------------
NOTICE
T( AND/OR OWNER
PARTIAL APPROVAL
VIOLATION
CORRECTIONS REQUIRED
]PERMIT
NUMBER
JOB ADDRESS
NO PERMIT - STOP WORK RE, MOVE CONSTRUCTION OR OBTAIN
PERMIT AND MAKE WORK COMPLY WITH BUILDING LAWS.
CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS
AND PERMIT - STOP WORK. MAKE EXISTING WORK COMPLY WITH
APPROVED PLANS AND PERMIT OR REMOVE IT.
STOP WORK - UNTIL A=ORIZED TO CONTINUE BY INSPECTOR.
CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN
BE APPROVED.
WORK DESCRIBED BELOW HAS BEEN INSPECTED AND IS APPROVED.
CONTACT INSPECTOR AND RECALL FOR INSPECTION
GE FOR APPOINTMENT. EIJ
THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED
2
WITHIN ...... A ...... DAYS OR PENALTIES IMPOSED BY
LAW MAY BE
APPLIED CTIONS CALL: PR 6-1107.
INSPECTION
?6- UILDING
INSPECTOR
DEPARTMENT
C�TY OF
2
> PLU-IN-
EDMONDS
DATE
RECORD OF INSPECTIONS
Date Passed
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F6undation
Plumbing (Partial)
(Rough)
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Frame �zj
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Furnztc.:,!�rueil-h s
a40 Final RECORD OF INSPECTION I S,
reDate a sed
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Drainage
Sewer
Parking
Landscaping
Fire Dept.
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