680447.pdf1"'.1 �M' o
7
POSTED ON IMOLL U&P NO.:
PERMIT
680447
U I ' DING
FPERNIIT
DEPARTMENT
Applicant Fill
1—s
NUMBER
7
APPLICATION
Inside Heavy Lines JOB
ADDRESS
A J
y
Z
8
X
w-o- g�ae
F,T) m 0 tq -D .5
"AA
a
or
Lai
1:;K-
SIDE
U I c,4.
�A D SET A
R
ET SETBACK REAR —YARI)BFTBACK
S_
NEW
RESIDENTIAL
I
n
GAS
LINE
NON-RESIDENTIAL
M
SIGN
ElDEMOLISH
RETAINING
WALL
ALTER
EXCAVATE
on FILL
FENCE
( .......... x . ........ Ft.)
El REPAIR
PRE -MOVE
INSP.
swim
POOL
DWELLING
UNITS
EXISTING STREET R/W .... ....... FT -
COMP. PLAN ST. R/W ............ FT.
FIRE ZONE I TYPE
SPECIAL INSPECTOR
[] YES [] NO
Plan Check No ............
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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-
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
7 t'on
r
d ste *t
ther b
a 'ha
duty
8 'a
t
a
'he
ut
Wa M
0 po h In"
0
relating to Workmen's Compensation Insurance. tat* of Waahln �0]
NOTE: Permit Limit One Year (Except DMIOLITIONS which
shall be completed In ninety days; MOVED.IN BUILDINGS shall be com-
pleted in six months.)
'IL BIG ED
SIGNATURE (OW14za un Ku� DATE SIGNED
71 .3 6?
A//
NOTE: Applicant Subject to Plan Check Fee
This rernalt coven work to be done on private Property urd"Y-
Any Construction on the Public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate percnisslon.
TOTAL AMOUNT DUE
ATTENTION
TIHS PER3IIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
Pit 0-1107
13 YES
DEFICIENCY THIS PROPERTY
0 0, [�)' 9
N
0 YES 0 No
No.
57
I r, 0 0 1 (4k 01
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-
knowledged in space provided.
?,3-
rum
' e
I&
4",
W07
RECORD OF INSPECTIONS
Date Passed
Foundation IA-t-Ve-r- 71 d 0
Plumbing (Partial)
XJO
(Roug rh)
Frame
Furnace & Fuel Lines
Final -9-= 7
RECORD OF INSPECTIONS
Date'Passed
&all 77
Top
k
I M