690368.pdfa
BUILDING DEPARTMENT I Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
Seattle, Wn
� :2 �r 2/ 9
02-
I
Li. 2—
I- IS"
iscription of Property*(Show loolow or Attach Four C
The W, 1601 of Tract 2—Wallace
except the N. 15-6 of the 014-05
thereof and the E 2kg—.08of Tr
Wallace Tracts
A 5
ON KROLL MAP NO.:
119 E
RESS
41 Puiret Drive
EXISTING STREET R/W .......... J"-
COMP. PLAN ST. R/W ............ rr.
I/ 1 -.2 //
PERMIT
NUMBER
690368
13 YHS
E3 NO
DEFICIENCY THIS PROPERTY
............ IT.
I
[] YES E3 NO
NEW
ADD
ALTER
REPAIR
RESIDENTIAL
NON-RESIDENTIAL
DEMOLISH
EXCAVATE
ElOR FIT-T
PRE -MOVE
INSP.
El
GAS
LINE
SIGN
RETAINING
WALL
PENCE
swim
POOL
0 YES [3 NO
PLAN CHECKED BY
REMARKS
Plumbing insbaMat ion per 1067 UPC and
attached E B D notes. Stack test roof drain
IUM13ER OF STORIES
NUMBER or
DWELLING
UNITS
+nside buildingo
'TATURE OF WOIER--TO BE DONE
I
Valuation
Fee
Receipt r
PLUMBING
I bereby acknowledge that I have read thin 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
wlII be employed In violation of the Labor Code of the State of Washington
relating 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.)
NO& Applicant Subject to Plan Check Fee
Thin Permit coven work to be done on private PrQP6dY ONLY.
Any tonstruction an the public doncein (eurbs, sidewalks, driveways,
nesRuees, etc.) will rcqntrs Separate permission -
Plan Check No....
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
M
TOTAL AMOUNT DUE 00 16-11
ATTENTION APPLICATION APPROVAL
THIS PERMIT Tltis application is not a permit until
AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ac-
I Imowledged in space provided.
INSPECTION DIRECTOWS N
DEPARTMENT
CITY OF A
EDMONDS DAITE255X
D51 E
F I C_
PR 6-1107 F 2
I FILE
ex