690305.pdfp
I ' G ;, DEPARTMENT I AppUcant FM
r APPLICATION '=`do Her 1"es
1"M OF Sual"
._!5) a
Q-4- *4e . IW A/I
5Z Mpuon OFT
A"
NEW RESIDENTIAL GLJNE
I R NON-RESIDENTIAL SIGN
F-1 AV" RETAINING
r_1 DEMOLISH WALL
ALTER EXCAVATE FENCE
r-1 OR BILL El ( ......... X.. Ft.)
PRE -MOVE SWIM
REPAIR INSP. 1:1 POOL
DWELLING
UNITS
PERMIT
NUMBER
TBA kC
r
j�AR YARD 8
V :7T SrrE
0 YES 13 NO
VA-R—V �
TANCE NUMBER
EN38TING STREET R/W ............ FT- DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R/W ............ FT. ............ FT. 0
REMARK5 9
I hereby acknowledge that I have read this application; that the in-
formation given to 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-
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 COMPerBILUOR InSuMMM
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shall be completed in ninety day MOVED -IN BUILDINGS shall be
pleted in oil months.).
z 7
NOTEf" Applicant Subject to Plan Check Fee'
This Permit coven work to be done an Private Property ONLY.
Any construction On the public domain (curbs, sidevralks, driveways,
marquees, etc.) WW require 501'arate permission'
0 YES
REMARKS
6 -
PlanCheck No .....................
BUILDING
PLUM33ING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENVION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
YES t-i No
Fee I ReCelPt NO.
FRO
I U 0 V�01 %.� I
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building official or rds Dep-
uty; and f ees are paid, and receipt is aC-
lmowledged in space provided.
Tin.
AS -5eld�—. C14 J
0
c RECOOD OFINSPECTIONS
Date Passed
Drainage
Sewer.
Parking
Landscaping
Fire,Dept.'-!
I
L- .