680526.pdf-POSTED ONKROLL MAP NO.: PERMIT
680526
BUILDING DEPARTMENT Applicant M
NUMBER
Inside Heavy Lines
vy
PERMIT APPLICATION
JOB ADDRESS
NAME (OR NAME OF BUSINESS)
'7" _e3 0
—9*I—DEYARD `SETBACK STREET SETBACK REAR YARD SETBACK
RESS
a4l
BEa
USE ZONE OT AREA VACANT SITE
C LEPHON7E�NUMBEr—_
17� 7Y- X/F �77
E]YES
/Giklyl BUILDING AREA VARIANCE NUMBER
;6
F4
z
8
_11
4"_4 0
r8TREET R/w ........... XT.
PLAN ST. R/W ........... XT.
U
or
NEW
RESIDENTIAL
1:1
GAR [J YES
LINE PLAN
ADD
L
NON-RESIDENTIA J
F�
RETAINING REMAI
DEMOLISH
WALL
I
EXCAVATE
FENCE
ALTER
OR FILL
( x Ft.)
REPAIR
PRE-MOV13
INSP.
........ . ..........
SWIM
POOL
DWELLING
UNITS
Plan Check No ..............
PROPOSED USE
gr.e-
BUILDING
PLOT MAN (Indicate BUIlding setbacks, abutting streets)
PLUMBING
HEAT & GAS LINE
FENCE
t
SIGN
N
RETAINING WALL
SWIMIUNG POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
AeT,
.90r,4a7f
TOTAL AMOUNT DUE
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 rvgu-
ATTENTION
luting construction; and In doing the work authorized thereby, no person
will be employed In Violation Of the Labor Code of the State of Washington.
THIS PEnmIT
relatIng to Workmall-8 Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In ranety days; MOVE134N BUILDINGS shall be com-
pleted In six months.)
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks. driveways,
marquess, ate.) will require separate permission.
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PIL 6-1.107
=FICIENCY THIS PROPERTY
... ........ Im
Valuation
0 YES
Fee
M
z
A
No.
I k-5z -, -C::7 '9 14 1 (0 1
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.
I
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