690290.pdfBUILUINU DEPAKIMCF11 pplicant Fin
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-'N PERMIT APPLICATION Inside Heavy Lines J013 ADDRESS
NAME,LQP NAME OF BUSINESS)
SIDE YARD HETBA(
MAILING ADORE 7
USE ZONE
CITY NUMBILIR
T
HEIGHT
NAME
PLOT PLA
APPRT
A
9
I
or
NEW
L�J�RESIDENTIAL
GAS
LINE
El ---
1 1:1 NON-RESIDENTIAL
I
SIGN
RETAINING
WALL
ALTER
DEMOT-TRIT
EXCAVATE
OR FILL
[�J�E 4
Ft.)
REPAIR
PRE -MOVE
INSP.
.. . .......
r_-J'-9WIM
J'q POOL
DWELLING
UNITS
I ICZ
I hereby acknowledge that I have read this application; that the In.
formation given in correct; and that I ELM the owner, or the duly author-
Ited 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
relating to Workmen's Compensation Insurance.
NOTE: Permit Mmit One Yecir (Except DEMOLITIONS which
shall be completed In ninety days; IOVED-IN BUILDINGS shall be com.
plated in six monthx_.J J
2
Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the Public d0m&JR (curbs, aldewoOks, drivenvays,
marquess, etc.) will require sapamte pezraloslon.
- � F
PERMIT
NUMBER 690290
[J YES
JF
EXIST�'NG'STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
Z
Z
COMP. PLAN ST. R/W ............ FT. ............ IT. 0
REMARKS Z
Z
W
0014
O.K. to connect into sanitary sewerss
th no larger line than 2".
Pu TYPE OF CONSTRUCTION STREET IMPROVE
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[] YES trNo I -�J �
AdL IIZOW,06- ho;boe.
)0&7Z C17-11 6k01AJ4.4JCC__ 919
Valuation
Plan Check No ....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
00
� I lel. -0 0
No.
TOTAL AMOUNT DUE
o
C)q/
ATTENTION
APPLICATION APPROVAL
TIHS PER511T
This application is not a permit until
AUTHORIZES
eigned by the Building Official or his Dep-
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
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RECORD OF INSPECTIONS
Date?,
assed
J
-ol
Foundation
'2
'(Partial)
Plumbing
(Rough)
Frame
e
Furnace & Fuel Lin
Final
V/
V/ RECORD OF. INSPECTIONS
Date Passed,
101V
t
Drainage
Sewer
00 Parking
I'v- F)
Landscaping
Fire Dept.