690261.pdfr,
VILDING DEPARTMENT Applicant FIU
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WALL
EXCAVATE
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ALTER
OR FILL
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REPAIR
PRE -MOVE
INSP.
.......... ..........
swim
POOL
NUMBER OF STORIES
I NUMBER OF
DWELLING
UNITS
0—
... .........
'OSTED ON KROLL MAP NO.: PERMIT
NUMBER
b90261
OB ADDRESS
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IIDE YARD SETBACK
STREET SETBACK
REAR YARD SETBACK
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VARIANCE NUMBER
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IEIGHT
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:ET R/W ............ FT. DEFICIENCY THIS PROPERTY
ST. R/W ............ FT. ............ . M. 0
11341
__r_/ I I __V� I [:] YES ej NO
SPEVrAL INSPFCTO�R�REQUIRED OCCUPANCY GROUP
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Plan Check No
BUILDING
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BE AT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
e.
Valuation Fee Receipt No.
M
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 PERIMIT
This application Is not a permit until
relating to Workmen's Compenantlon. Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE* P Li 0 4-e (Except DEMOLITION'S which
Imit n '�r
9plated
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be c I elect d a ED-IN BUILDINGS "I ber
c plot
�alxmonthj
Imowledged in space provided.
pleted�
URE R AG r)
INSPECTION
DIRECTOR'S SIONATUR
DEPARTMENT
CITY OF
DATE 00-
Ll EDMONDS
NOTE: Applicant Subject to Plan Check Fee
Pit 6-1107
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks. driveways,
FILE
marquees, etc.) will require separate permission.
i I I
71