690243.pdfILDING DEPARTMENT Applicant Fill
i1WIT APPLICATION- Inside Heavy Lines
(IMINP-ME 0 B NESS)
E
LING ADDRESS - 7
-.0,2 -
( �*7 -
rARD H
1/,)
I
PERMIT
690243
NUMBER
ACK REKH YARD SETBACK
YES M49
MA
I VARIANCE NUMBMIt
STREE"I/w
-T.
TELEPHONL NUMB -Fit— EXISTING STREET R/W ............ r DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R/W ............ . M. ............ FT.
REMARK9
W
or
0 0 � j e-1 ,
PWOWH
RESIDENTIAL
GAS [3 YES
LINE
NEW
1
PLAN
1:1 NON-RESIDENTLALL
SIGN
41
ADD
DEMOLISH
F1
RETAIMNG
WALL
Q<TER
EXCAVATE
FENCE
OR FILL
( x Ft.)
REPAIR
PRE -MOVE
.......... . ........
swim
POOL
INSP.
IUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
4ATURE OF WORK TO BE DONE
OF CONS'j
v.
Plan Check No ................ . ...
BUILDING
PLUMBING
BEAT & GAS LINE
W CA I,A( 71
FENCE
SIGN
tRETAINING
WALL
N
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 In correct; and that I am the owner, or the duly author-
lzed agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
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
TIHS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DE510TATIONS which
ONLY TIM
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six monthu.)
1) TE IGNE
INSPECTION
DEPARTMENT
f
CITY OF
IL
EDMONDS
NOTE: Applicant Sub - t to Plan Check. Fee 7
PH 6-1107
This Permit coven work to be done an private property ONLY.
Any construction an the public domain (curbs, sidewalks, driveways,
marquess, ate.) will require separate permission.
Valuation
[] YES
Fee
0 0
M
No.
I I / C� L-11 I k �v L-1/ 7
APPLICATION APPROVAL
This application is not a pern-dt until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
__ j 41