690465.pdfISO!
6
C,
KROLL MAP NO.:
PERMIT
1DING DEPARTMENT
NUMBER 690465
I I
Applicant F9
AMM1111APAWIlIftlall
V__ A— Va.
.
U.AirriallivAllUn
1AK2 OF, BU
rll'..'I"'�: �:- ''
hlhn
S/&/
..�j JOB ADDREHIS
'/ -5� 5 — alp
,It- 3j_�Fd
7749:� �.2_4;z
ty (Show Below or Attach Four Copies)
e
AV;,
.4 'Z
S"NEW
RESIDENTIAL
GAS
LINE
I
NON-RESIDENTIAL
lljol,
ADD
E]
RETAINING
WALL
1:1
DEMOLISH
ALTER
F1
EXCAVATE
OR FILL
PENCE
( x Ft.)
REPAIR
PRE -MOVE
INSP.
........ . .........
SWIM
POOL
NUMBER or
DWELLING
UNITS
13 YES 0 NO
EXISTING- STREET R/W .......... rr. DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R/W ........... XT. ....... .... 1".
[] YES C3 NO
NATULt,30 OF WORK TO BE DONE
Plan Check No ..................
BUILDING
PROPOSED USE
PLUMBING
BEAT & GAS LINE
PLOT PLAN (Indicate Building setbacks, abutting streets)
FENCE
SIGN
RETA.INING WALL
SWnCMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
t the In'
I hereby acknowledge that I have read this Application; that the in-
author
formation given in correct; and that I am the owner, or the duly author,
w -
Ised agent of the owner. I agree to comply with city and state laws regu-
a regu,
ATTENTION
0 person
lating construction; and In doing the work authorized thereby, no Damon
"bIngto
will be employed In violation of the Labor Code of the State of Washington
THISPERMT
misting to Workmaire Compensation Insurance.
AUTBOIUZES
NOTE: Permit Limit One Your (Except DEMOLITIONS which
ONLY TILE
WORK NOTED
be com.
com_
shall be completed In ninety days; MOVED4N BUILDINGS shallij
plated in mix months.)
IIGNATU RE (OMER OR AGENT)
810 N ED
INSPECTION
a
DEPARTMENT
e
lavu3DATE
/
CITY OF
- 11
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
Pit 6-1107
This Permit covers work to be done on private property ONLY.
Any construction an the public domain (eurba, sidewalks, driveways,
manuees, etc.) will require separate permission.
Valuation
E3 YES 13 NO
Fee
M)
I Ao. 11
APPLICATION APPROVAL
This application to not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac-
lmowledged in space provided.
FILE
m�
��vim M. �,"ii
�I;lr" VVgq ell I
I'lltI.Tllv I in
1 19
-,I I IT ql I, b I T,I IT, ll. I f'-V4: NQ
I'l: It
lei
411
IL AI -14 4 4. tv-0
'it l 1.- 4 � p r 41
--41 rd T; v it �. I, 'tli
I, , i4 I
IIII.Ilri—
. IT "'T. 1 1 1 1
ji I IT
III il, I �-4 1
k'.! lVe I;,A� sp
0 4
7i
4T
It
ILI
I I lit
VI
441
IT
CA T* fAid iJ
IT
-0 .... LT.,
ILI,
IT,IT '-IL
..1114
j JLL
i k
I Or
rr 9 LT. L 'LL
IT, ll. ......
�Jlt, I-0 IT "'ip'j " ,' "'� I
of L'
IT L 9 L"'
I Is
L L ""LIT I 1 .10
IT
TO
MI
tl IT L It
rill ""st'
IT I T
L L IT
It
ITT Tilt,
"Til
A 'L 9t
L* PO ;I�Iflt
tit.
r lkl"I L I Ile gIi. "Til L,
4tl L ..... it 4 Lj �pq I"
4 L I I I
it
'fQ
I ILI I
9L L, it p I t' . p
i
IL I— RECORD'OFd INSPECTIONS
Date Passed 9
'LL I
�4:t i I I"A .
p 99- 1 9.� I Foundation
9 alga L
r 9 Plumbing (Partial)
9 1 1 1 IT. (Rough) 1 2 woo
-L ''Lit Frame
ILI
9 L Furnace & Fuel Lines�
9 9 Final
L,41
RECORD OF INSPECTIONS
Date Passed
Drainage
Sewer
Parking
I :' I'L� IT, I
I
T Undscaping
Fire Dept
It
F