680436.pdfLDJING DEPARTMENT Applicant Fill
"lot, APPLICATION Inside Heavy Lines
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IFR_0FOSED USE
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PLOT PLAN (Indii—ato Building Setbacks, aE—utting streets)
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I hereby acknowledge that I have read this application: that the in-
formation given to correct; and that I am the owner, or the duly author-
lzed agent of the owner. I agree to comply with city and state laws regu-
I&tlng construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
relaUng to Workman's Compensation Insurance.
NOTE: Permit Limit One Year (Except DE31OLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be corn.
pleted In six months.)
V NOTE: Zpplicant Subject to Plan Check Fee
_ihis —rerudt coven work to be done on private Property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, ate.) will require separate Permission.
FSTED 'ONICROLL MAP NO.: PERMrr
NUMBER MIA%
)B ADDRESS
.;2 " _I;z 0 Al eg�4,, Y
IDE ,YJ�RD SETBACK STRENT kJNW"ACK� REAR YARD SETk
/?7A-Ki. 23, 1774-�
% 4:21
EXISTING STREET R/W ............ FT.
COMP. PLAN ST. R/W ............ FT-
0 YES
Plan Check No.
BUILDING
PLUMBING
mm
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATMNTION
THIS PETBUT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDAIONDS
PR 6-1107
[3 YES,
DEFICIENCY THIS PROPERTY
0 YES 0 NO
Valuation
APPLICATION APPROVAL
This application is not a permit until
signed by the Building official or his Dep-
uty; and fees are paid, and receipt is ac-
lmowledged In space provided.
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D OF IN
RECOR SPECTIONS
Date Passed
Foundation
Plumbing (Partial)
(Rough)
Frame
Furnace & Fuel Lines
Final
RECORD OF INSPECTIONS
Date Passed.
Drainage ---
Sewer
Parking
Landscap ing
Fire Dept..
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