690341.pdfN
BUILDING DEPARTMENT
� PERMIT APPLICATION
f 0
—Oa—
N
D ON VROLL MAP NO.: PERMIT
Applicant I= NUMBER 690341
Inside Heavy lAnes JOB ADDRESS
TELEPHONE NO:
J L4
�LL
TELEPHONE NT
or
NEW in RESIDENTIAL
I
GAS
LINE
El
NON.RESIDENTrKL
SIGN
ADD
RETAINING
DEMOLISH
WALL
ALTER
EXCAVATE
OR FILL
FENCE
( ........ . x . ........ Ft.)
REPAIR
PRE -MOVE
INSP.
swim
POOL
NUMBER OF
DWELLING
Q,
UNITS
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 rogu-
I&ttng construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
rglating to Workmen-s Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be oom-
pleted In six months.)
EXISTING STREET R/W ........... FT -
COMP. PLAN ST. R/W ............ FT.
or
[] YES [3 NO
Plan Check No....
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
Ofli_,d7�q_vl 1,157,W
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done onprivate property ONLY.
Any construction an the public domain (curbs, sidewalks, driveways,
ntarquees, etc.) will require separate permission.
13 YES
a NO
DEFICIENCY THIS PROPERTY
[3 YES [3 No
Fee
TOTAL AMOUNT DUE
ATTENTION
APPLICATION APPROVAL
THIS PERMIT
This application is not a pemilt until
AUTHORIZES
signed by the Building Official or his Dep-
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
lmowledged in space provided.
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
FILE
I
IT.
.1 It 4 t
it
P.4
CIA I I 'a.
It
� " f, .,
L
t7
I I I 'I I
tit
Ott t t,
It I . I L. I I I I I I. I.
�z kV
IT It
It 1 L, . I "Itt 'I�
It:
VL
t I
MI,t.
t I
I
It
It
I
I
It.
IV It I ;I I
Alt I t I rr r I 1 5 r k 1 1, 1, 1 f It 11 1 1 . . . I . I . . .
it t� t
It I
1 2
ECTIONS
T td
-Z RECORD OF I NSP
Date Passed
I IF 11 4 r j
�1- Toundation
Plumbing ( Pa rt I a I
r I
VIVO
(Rough)
Frame
Furnace. & Fuel
7
C, Fi na I
CA.V.01/
I
'r- ;I. 1 .4
I I, L I I
I r all I I I . . . L L L
It
IA
jItp tr L r t
It
L D NSPECTIONS
L t 1. REOR *'t(jF' 1
I L
Ik r r r
It It III
It I
L 'L po
15
Sewer
It
iq
�--, J. t L it Z: 71�
;�V ItItIr. VI-
4 4 1.,. Awl W.* V
0 Parking
I) I, , -'. I I % , A !tII,
Tii� l I, V I A a L 0 L
It It,
Landscaping
N I
tot I t I d I 1 0
VL Xf 0
Fire Dept.tivif It. IIIIJ1., t
I':IIIA I- li jj
I dd
I
W
r I I I
I
1
40
rt
I
X4 I
It I
r I
I
It
14
It
rr I
It
,
It
L
Ir