690436.pdfBUILDING DEPARTMENT
PERMIT APPLICATION
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Applicant FIR
Inside Heavy Lines
Adve,rice Plunibinj-;
Tr_2t_1nE,, 11-1c
ADDRESS
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CITY
TELEPHONE NU:
87ARYL-LIffEWIM NUMBER
LICENSE D
1) 16 r� tS " --- 7 0
1 I -peal DescriDtIon of Property
(Snow Below or Attach Four Cc
Fx� NEW
RESIDENTIAL
GAS
LINE
NON-RESIDENTIAL
SIGN
DRETAINING
DEMOLISH
WALL
ElALTER
0
EXCAVATE
El
FENCE
Ft.)
OR FILL
( ........ . X ..........
REPAIR
F-1
PRE -MOVE
INSP.
SWIM
POOL
4UMBER OF STORIES
NUMBER OF
DWELLING
UNITS
�-1 �10:� t
PERMIT
NUMBER
noilds. 7,.:
[] YES [3 NO
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ FT. 0
REMARKS
C] YES C] NO
REMARKS
ir rin!
cd Plan Check No ............ . .......
BUILDING
PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE
PENCE
SIGN
tRETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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 regu-
lating construction; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: PerrnitUmft One Year (Except DEMOLITIONS which
shall be Complete
,P,ln ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six njoliths.)
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NOTE: Applicant Subject to Plan Check Fee
This I-ermlt coven work to be done on private property ONLY.
Any construction on the public domain (curb@, sidewalks, drlveav&Ys,
marquceso etc,) will require separate pernals0on,
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 0-1107
STREET IMPROVED
0 YES [3 No
Valuation
4:
14
No.
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APPLICATION APPROVAL
This application is not a permit until
eigned by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged In space provided.
Dl��CTOR
Is
Landscaping
fire Dept.