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PERMIT APPLICATION inside Heavy Lines
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ADDRESS
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CITY
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PERMIT
Sr &/-** I NUMBER 6900023
POSTED ON KROLL MAP NO-:
B ADDRESS t6
BIDE YARD SETBACK STREET BET13ACK IUU�% ZARD SETBACK
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USE ZONE LOT AREA VAUANX arm
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TELEPHONE NUMBER EXISTINW�;REET R/W ..a XT.
COMP. PLAN ST. n/wAAQ.._rr.
774-7707 REMARKS
Driveway slopes not ti
TZ-5 I indicated on Standard
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7-74--170
or
RESIDENTIAL
GAS
LINE
NEW
NON-PMIDENTL4,L
SIGN
RETAINING
WALL
DEMOLISH
ALTER
EXCAVATE
OR FILL
El
FENCE
I .......... x 111t.)
. ........
REPAIR
PRE -MOVE
INSP.
swim
POOL
NUMBER OF.
DWELLING
UNITS
qATURE OF WOR 110 BE DONE
PROPO13ED us)
S I f_�- C�L_
PLOT PLAN (I
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Building setbacks, abutting
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to
CITY C)i-
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I hereby acknowledge that I have read this application; that the In-
formation given in 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
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit Ono Year (Except DEIMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be corn.
Pleted In six months.) .
- 4.1e't
NOTE: AhfiWn't Subject to Plan Check Fee
This Permit covers work to be done on private Property ONLY.
Amy construction on the public domain (eurbs, sidewalks. driveways.
marqu"s, ate.) Will require separate permission.
[3 YES [] NO
Plan Check No....
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
WIAX-11"AR-tyl-115 �11 �
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PH 6-1107
DEFICIENCY THIS PROPERTY
I
13 YES [3 NO
Fee
I I ( 0.!5 0 �f 11.9,
APPLICATION APPROVAL
This application Is not EL permit until
sigmed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
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