690090.pdfSTED ON KROLL MAP NO.: PERMIT
NUMBER
BUILDING DEPARTMENT Applicant Flu 6C)0000
Inside Heavy Lines JOB ADDRESS
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PERMIT, APPLICATION
IN You I a I I
SIDE YARD SMTBKCK STREET SETBACK YARD SETIJACK
k I f
I AS' r
G ADDRESS rrl� A1%14 _n VACANT SITE
P.I CL- USE ZONE LOT AIW* A
TELEPHONE NUMBER YES NO
ARIANC NUMBER rA
A lqm, 4 q (PS'C) HEIGHT BUILDING AREA
PLO PROVED
Be 7; 3
ET ]f/)V r
EXISTINdfiTREET R/W DEFICIENCY THI13 PROPERTY
TELEPHONE Nu
COMP. P T. R/W S—IFT. 0
LAN 8
REMARKS
:o exceed those
Drivewgy.siopes not I
dard Drawing #103. C
indicated on Stan
Z
HECKED BY
CITY TELEPHONE N MHER
ZE SERVICE ISIZE U"A�Nuc� IC C DBY
I METER 81
UMBER CITY LICENSE NUMBER
�,flITATZ LICENSE N 1
Y_
NJ
Legal Description of Property (Show B7ow or Attach Four copies)
TYPE CON14ECTION VEMY BY
HER
T 1of PERO. TEST PERMIT%nUM
(A A 4 A� REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
I [] YES
CUPANCY GROUP -
SPECIAL INSPECTOR REQUIUZU VU
RESIDENTIAL GAS 0 YES Y 0
NEW LINE PL . A I N
NON-RESIDENTIAL F-1 SIGN
RETAINING 'REMARKS'
AIJU El DEMOLISH WALL
FENCE
ALTER EXCAVATE
F� OR FILL .......... x .......... Ft.)
PRE -MOVE swim
REPAIR F-1 INSP. POOL
NUMBER OF
DWELLING
UNITS
NATURE OF WO 0, BE DONE�
Valuation Receipt No.
Vain
D No . ..................
Plan Check No .....................
plan C k
.4 PROPOSED USE
:
BUILDING
6 0
PLOT PLAN (Ind
PLUMMNG
22
0
HEAT & GAS LINE
'T
FENCE
t
SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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-
the owner. I agree to comply with city and state laws regU.
ATTENTION
APPLICATION APPROVAL
ized agent of
latlng construction; and in doing the work authorized thereby, no person
violation of the Labor Code of the State of Washington
THIS PERMIT
This application Is not a pernitt until
will be employed in
relating to Workmon'S Compensation Insurance.
AUTHORIZES
signed by the Building Official or lits Dep-
NOTE: Permit Limit one Yetir (Except DE31OLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be completed In nicety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
pletol�nif months.)
(OWNN DA SIGNED
INSPECTION
DEPARTMENT
DIRECTOR-8 JIGNA
:7 dr- 70 -
L -
CITY OF
A 10
EDMONDS
3—
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This Permit Covers work to be done an private pro ty ONLY.
Any construction an the public domain (curbs, sidewalks. driveways,
FILE
marque,es, etc.) wilt require separate permission.
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' y_ RECORD OF INSPECTIONS
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Plumbing (Partial) �
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(Rough) -
Rame
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Furnace ~-
Final
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RECORD OFINSPECTIONS
� Date Passed
� Drainage
Sewer
Parking ---------�
� Landscaping --------
Rw Dept.