690091.pdfPOSTED ON KROLL MAP NO.: PERMIT
BUILDING DEPARTMENT NUMBER 690091
Applicant F
Inside Heavy Lines joB ADDRESS
NAME F uSI
PERMIT APPLICATION
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HEAR YARD SETBACK
SIDE SETBACK
YARD SET"ALM
,�T
MAIUNG ADDRESS
4 I'l P-L P% USE ZONE AREA VACANT SITE
Effi HONE N i—misrin
-U,—Ty
X(YEB E3 NO
04.Q cci HEIGHT ..U�NCE NUMBER
NAME
P ED
LO ov
T P
ADDRESS
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STRE n
'EET R/W DEFICIENCY THIS PROPERTY
CITY TELEPHONE NUMBER
COMP. PLAN ST. R/W..= ... IT. 0
REMARKS
NAME
nriveway slop?.s not to gxceed those
indicated on ataRad standard'Drawing
,�ADDP=S
14
HECKED BY
TELEPHONE NUM BER
METER, SIZE SERVICE SIZ CLEARANCE CHE
ITY LICENSE NUMBER
LICENSE NUMBER C
yo
REMARKS
Legal Description of Property (Show Below or Attach Four Copies)
TYPE CONNECTION VERIFIED BY
T�- + L n PERO. TEST PERUIT\YUMBER
REMARKS 02
G
jt- 4
FIRE ZONE TYPE OF,,CONSTRUCTION STREET IMPROVED
El YES
SPECLkL INSPECTOR QUIRED OCCUPANCY GROUP
GAS
0 YES
NEW RESIDENTIAL LINE PLAN CRECKPIRIBY
ElNON
-RESIDENTIAL SIGN - REMARK
D ADD RETAINING
DEMOLISH WALL
E]
ALTER EXCAVATE PENCE
OR FILL El ( .......... x .......... Ft.)
PRE -MOVE swim
REPAIR INSP. POOL
F - 11
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
Plan Check No .....................
t
PROPOSED UBE
BLILDING
PLOT PLAN (Indicate Building setbacks, abutting streets)
PLIJIUUNG
HEAT & GAS LINE
PENCE
t
SIGN
N
RETAINING WALL
SWIMM No POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FULL
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-
Ized agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
APPLICATION APPROVAL
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
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZE&
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DE51OLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
Imowledged in space provided.
pleted In six months.)
GENT) DATE SIGNED
INSPECTION
DEPARTMENT
:D:1RWECTOIRV'8�=SIGNAT7,U
CITY OF
AT'
Fee
EDMONDS
NOTE: Applicant Subject to Plan Check
Fn 0-1107
This Permit covers work to be done on private property ONLY.
Amy construction an the public domain (curbs, sidewalks, driveways,
FILE
marquess, ate.) will require separate permission.
� I A
- ----- -----------
RECORD OF INSPECTIONS
Date Passed
Foundation
AV
Plumbing (Partial)
(Rough) -24,-?V
Frame
Furnace & Fuel Lines
Final
P
RECORD OF IN SPECTIONS
Date Passed
Drainage
Sewer
Parking
Landscaping
Fire Dept.