690421.pdfEll
POSTED
BUILDING DEPARTMENT Applicant Fill.
PERMIT APPLICATION Inside Heavy Lines —jOj3ADD,
MAP NO.: PERMIT
NUMBER 690421
P%-_ . S - %-AD -
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t VACANT SITE
USE ZONE LOT AREA
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WJUL�WPIIVNE Nu No
HEIGHT BUILDING AREA VAIUANCE) NUMUMER 0�4
I.CA— 171-1 Fr-9 5-9
EXISTING- STREET n/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ Fr. ............ VT.
or
=ME& M a W'W-'W� .�: WW#*)X*19NRMq') [$N�WVMO $4 $0 On W4
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El YES 13 XO
150
RESIDENTIAL
FI
GAS [] YES [] NO
LINE
NEW
PLAN CHECKED BY
ILINOW-nESIDENTIAL
SIGN
ADD
DEMOLISH
F-1
RETAINING REMARKS
WALL
Eo �1 4F 5-
ElALTER
EXCAVATE
OR FILL
F�
PENCE
( x Ft.)
REPAIR
PRE -MOVE
INSP.
........ . ..........
swim
POOL
ZUMBER OF STORIES
NUMBER OF
DWELLING
er3
UNITS
Plan Check No ........
BUILDING
PLUMBING
HEAT & GAS I=
B
P
FENCE
SIGN
U
L
'E M
U
A
N
G
M
T
C
N
D
tRETAINING WALL
N
8 S WMM
WIMMING POOL
DEMOY.
DEMOLITION
PRE.Mj
PRE -MOVE INSPECTION
XCAV
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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-
ized agont of the ov6mor. I agree to comply with city and state laws regu- ATTENTION
lating construction; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of W'ashington TIUs rERDIXT
'y ' he 'In'
u" or -
we regu-
e a� n
no p �
la3hin n
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted la six months.)
R R AGENT DATE 81 INSPECTION
GNED
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee PR 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the Public domain (curbs, sidewalks, driveways.
marquees, etc.) will require separate permission.
Valuation I Fee
No.
I 162).-V
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
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Date Passed C,
,Foundation
P I :-Plumbing (Partial)
(Rough)
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:--Furnace & Fuel Lines
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