690330.pdfLy
690330
KROLL MAP NO.: PERMIT
NUMBEIt
Fill
-.L"Dj N G DEPARTMENT Applicant
Xnaide Heavy Lines JOB ADDRES11—
IT APPLICATIO14
74th Place We
690330
KROLL MAP NO.: PERMIT
NUMBEIt
Fill
-.L"Dj N G DEPARTMENT Applicant
Xnaide Heavy Lines JOB ADDRES11—
IT APPLICATIO14
74th Place We
TELEPHONE NU
wn,
743-0093
TELEPHONE N�
T-
TELEPHONE Nt
STATE LICENSE NUMBER
CITY LICENSE
Legal Description of Property (Show Below or Attach Four C
E]
NEW
:Ij RESIDENTIAL
INON-RESIDENTIAL
ADD
DEMOLISH
ALTER
EXCAVATE
OR FILL
REPAIR
F1
PRE -MOVE
INSP.
DWELLING
UNITS
Plumbing
GAS
17
LINE
SIGN
RETAINING
WALL
PENCE
( ......... x . ........ Ft.)
SWIM
POOL
— 74th Place West
13 YES 13 NO
sk
EXISTING STREET R/W ............ FT.
COMP. PLAN ST. R/W ............ FT.
[3 YES [3 NO
DEFICIENCY THIS PROPERTY
... ........ Fr.
13 YES
0 2� IF
[:] NO
No.
Plan Check No ...................
BUILDING
PLUMBING (7)
HEAT & GAS LINE
FENCE
SIGN
tRETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
I EXCAVATION OR FILL
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-
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 -a Compensation Insurance.
NOTE: Permit Limit One Your (Except DEMOLITION8 which
shall be completed In ninety days; MOVED -IN BUEEMINGS shall be oom-
plated in six months.)
NOTE: Appticant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction an the public domain (curbs, sidewalks, driveways,
marquess, ate.) will require separate permission.
I
TOTAL AMOUNT DUE
AT=NTION APPLICATION APPROVAL
TMSPEnMT This application is not a permit until
AUTHOnIZES signed by the Building official or bis Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION
III ATU
DEPARTMENT
CITY OF
EDMONDS
PH 6-1107
DATE
C�'
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