690383.pdf........ . . . . . .
:)N KROLL MAP NO.: PERMIT
BUILDING DEPARTMENT Applicant Fill NUMBER 690383
PERMIT APPLICATIO14 Inside Heavy Lines jug ADDRESS t
I NAhW (OR NAME OF BUSINESS)
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NEW
TARESIDENTIAL
H
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LINE
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'NTIAL
NON -RESIDE=
SIGN
0 ADD
RETAINING
WALL
ALTER
DEMOLISH
EXCAVATE
PENCE
F1
OR FILL
( .......... x . ........ Ft.)
RUPAIR
1:1
PRE -MOVE
INSP.
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swim
POOL
4UMBER OF STORIES
NUMBER OF
DWELLING
UNITS
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YES U Nu
EXISTING- STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ PT.
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SPEC17M—INSPE;CTGR
0 YES
,,UEQUIR
No
Plan Check No ..... ..............
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
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ETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby aanowledgo that I have read this application; that the in.
formation given Is correct; and that I am the owner, or the duly author-
lzed 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 Coda of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Lirqit One Year (Except DEMOLITIONS which
shall be completed In nthety 41YE: MOVED -IN BUILDINGS shall be oom-
pleted in mix mynths. )7.
NT) DATE rl(�N'FD
NOTE: 4plicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, 1.1doWalks, driveways,
marquees, etc.) will require separsite permission.
Valuation
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[] YES
Fee
M
T TOTAL AMOUNT DUE
OTAL
ATTENTION APPLICATION APPROVAL
TIUS PER511T This application is not a pem-dt until
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AUTHORIZES
_ H TI ] signed by the Building Official or his Dep-
ONLY TILE
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= N
WORK NOTED uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
INSPECTION D—IRECTOR'S SIGNATU�,
P RTMZ
DEPARTMENT
C Cl Y Ol
ITY OF e���-Ior
D4WXF
EDMONDS
PR 6-1107
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