690380.pdfB UILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
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NAME (okt riaxr, ur'BUSINESS)
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NEW
12 RESIDENTIA
R
GALS
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NO
El
I
NON -RESIDE: TIAL
SI(
ION
ADD
RETAINING
WALL
DEMOLISH
E]
ALTER
EXCAVATE]
OR FILL
FENCE
Ft.)
..........
REPAIR
PRE -MOVE
INSP.
SWIM
POOL
NUMBER OF
DWELLING
0 N
UNITS
-ft'j, bezodoms.
PERMIT
NUMBER 690380
ADDRESS
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0
YARD
SETBACK STREET SETBACK
REAlt ijum SETBACK
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0 ZONE
LOT AREA
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YES XNO Z
nwm
I BUILDING AREA
I VARIANC15 NUMBEkt I ow
EXISTING STREET R/W ........... XT
COMP. PLAN ST. R/W ............ FT
or
[] YES 0 NO
Plan Check No ............
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
tRETAINING
WALL
I
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
DEFICIENCY THIS PROPERTY
[] YE13 [] No
Z
N
V
r4
E"
9
No.
9
NT
TOTAL AMOUNT DUE
TOT" AMOU
I hereby acknowledge that I have read this application; that the in-
formation given is correct: and that I am the owner, or the duly author -
teed agent of the owner. I agree to comply with city and state laws regu-
T
A I(
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby. no person
7:
will be employed in violation of the Labor Code of the State of Washington
THIS PERMIT
T 8 E RM
This application is not a pem-d t until
relating to Workmen's Compensation Insurance.
AUTHORIZES
AUTHORIZI
signed by the Building Official or We Dep-
NOTE: Permit Limit one Year (Except DEmOLITIONS which
ONLY THE
ODrLy TH]
RK NOTJ
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
Imowledged in space provided.
pleted In six months.)
FI—GNUTURE (OWRER OR AGENT) LWM SIGNED
INSPECTION
DIRECTORIS TU
10114) 111bj.
DEPARTMENT
Y 01
CITY OF
CIZ
EDMONDS
DATEC�,-
NOTE: Applicant Subject to Plan Cbeck Fee
PR 6-1107
This Permit covers work to be done an private Prol)"IY ONLY.
Any construction an the public domain (curbs, sidewalks, driverways,
marquees, etc.) will require separate permission.