680482.pdf':' ,,BUILDING DEPARTMENT Appumnt Fin
TERMIT APPLICATION Insme l3eavy L'ass
ADD
ALTER
IMPAIR
0 e
I
r
/4�� X4- 5-Ad
or
RESIDENTLALL
GAS
LINE
ry
NON-RESIDENTL&L j
SIGN
DEMOLIS11
EXCAVATE
OR FILL
RETAINING
WALL
PENCE
( ........ . x ......... Ft.)
PRE -MOVE
INSP.
SWIM
POOL
DWELLING
UNITS
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-
ized agent of the owner. I agree to comply with city and state laws ragu-
lating construction; WW In doing the work authorized thereby, no person
will be employed in violation of the Labor Code Of the StAts Of Washington
relating to Workmenox COmPcnMtIOU Insurance -
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shall be completed In ninety days; MOVED.IN BUILDINGS alual be com-
pleted In six months.)
e,K&f -4
Ae-ez I /ell_ 1,7
N&E: APPlicant Subject to Plats Check Fee
ThI& routs coven work to be done on private property ONLY.
Any eanglzuellon an the public domain (curb@, sidewalks, drlv&waysp
mwquwg, oft.) will require sellsratO permission.
�.M
EXISTING STREET R/W ........ ... FT -
COUP. PLAN ST. R/W ............ FT.
OF
[] YES 0 NO
Plan Check No....
BUILDING
PLUMBING
BEAT & GA13 LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
2`1118 PERAJIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
PERMIT
NUMBER
01...) P_
y
Tice 13 NO
MIANCE _9UUHER
DEFICIENCY THIS PROPERTY
13 YES [3 NO
vo
I
No.
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-
Imowledged in space provided.
FILE
f
J
% Y
P "f
at 4partor of "Utheast 4wartor of &action U&
0 a most# won@ 6*804bod as folloves
W Or Intersestilm of the sentorline of sees"
tit
the Goater Ua* of Newport ATeMop all as dw= on We
41as of With a""" W asserting ViLat %"Few
resords of 111mehiesila ownsfts
volimme
LIP along fte said Seaf L
k4 L I A or U"
*seem strosto toot to site rue point or beglaning or ftle 406WJ L.
t1saj ftouso# fron said polat Or boglanlage nm 11"rthw**%ej%j* L, '.�;r
L lot with ww soutor use or seavort Avenue, iso reetj thons* 14thwe"M L
sely pentlel idth Mw seater line or Somsend 111trooto so toot, %hqnoo
&ZIerly pw&U*3. ulth the senter 11a* or Woorport Avnmg UM
feett thease Wrtho"torly& &1ong said "star line of Sesond Rrest*
L
'L
to the volat or beglaningo
r
L I r r
I f r, L
L RECORD OF INSPECTIONS
L I
L L Date Passed
Foundation
L, Plumbing (Partial)
(Rough) L
L
Frame
.1 P
Furnace & Fuel Lines--��,
Final L L
(AM000 L .11 .1 1-, L
L RECORD OF INSPECTIONS
Date Passed
Drainage �7,
Sewer LL'
Parking
Landscaping
Fire Dept.
4 L
1a;
17
t