690230.pdft
mmmsisses' POSTED ON KR(
1-0-U-ILDING DEPARTMENT Applicant FLU
PERMIT APPLICATION Inside Heavly Lines JOB ADDRESS
NAME (0,4 NAME OF BUSINESS
9� NEW
0 ADD
ALTER
REPAIR
PERMIT
NUMBER
690230
)90230
USE ZONE
LOT AREA VACANT SITEI
—ifE—LEPHONE NUMBER
YES E3 NO
214�
HEIGHT
BUILDING AREA VARIA CE NUMBER
9k
P ED
REET
PROPERTY
DEFICIENCY THIS PROPERTY
TELEPHONE NUUBER
COMP. PLAN ST. n/W
........... XT- ............ XT.
a
REMARKS
CHECKED BY
I
TELEPHONE NUMBER
I
I I
METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
NUMBER CITY LICEN13E NUMBER
REMARKS
of Property (Show Below or Attach Four Copies)
TYPE CONNECTION
VERIFIED BY
PERC. TEST
PERMIT NUMBER
REMARKS
FIRE ZONE TYPE Or CONSTRUCTION STREET IMPROVED
YES Nc
SPECULL INSPECTOR REQUIRED
JOCCUPANCY GROUP
RESIDENTIAL
1:1
GAS
LINE
NON-RESMENTLILL 1
0
SIGN
DEMOLISH
RETAINING
WALL
EXCAVATE
OR FILL
PENCE
( ........ . x . ........ Ft.)
PRE -MOVE
INSP.
SWIM
POOL
DWELLING
UNITS
N
r] YES [3 NO
I
shed on this property owned by Theo. B.
Tafte
Plan Check No....
BUILDING
PLUNWNG
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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 -
tied 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
tion
or the
L d eta
n I
I thereby
d
a
t
'y awl"
au
th
re
on]
r
gu
on
ta of no h pe� on
te Was
relating to Workmen's Compensation Insurance.
NOTE: Permit Umit One Year (Except DEMOLITIONS which
W
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted in six months.)
1) TZ
SIGNATURE (OWNER OR AGENT) DA1,11; SIGNED
NOTE: Aptlicant Subject to Plan Check Fee
This Permit coven work to be done ark private property ONLY.
Any construction on the public domain (curbs. sidewalks, driverways,
manuees, etc.) win reqnIra separate permission.
TOTAL ABIOUNT DUE
ATTENTION
THIS PERM[IT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
Valuation
0 C)
No.
APPLICATION APPROVAL
This application is not a permit untU
signed by the Building Official or Ms Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
APPLICATION APPROVAL
This application is not a permit untU
signed by the Building Official or Ms Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
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Date Passed
Foundation
Ik
Plumbing (Partial)
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-LIr (Rough)
Frame
4'
L Furnace & Fuel Lines.
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'INSPECTIONS
RECORD 'b� f,
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4 Da s e
Drainage,,.
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44
Sewer
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Fire Dept.
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