700040.pdft POSTED ON KROLL MAP NO.: PERMIT
-7
BUILDING DEPARTMENT Applicant FiU NUMBER 100040
PERMITAPPLICATION Inside Heavy Lines j(jjj ADDRESS
NAME (OR NAMIG OF BUUINESS) -7 '7,aV, 15;�2
-7 -2a4l— Zga
CITY
15
Ej
:4
5 06
PAV
. S
or
hRD��BACK
STREET SETBACK
IjEAR YARD SETBACK
7
/S— 0
.01s_
?NE
LOT AREA
VACA.NT SITE
0 YES )(NO
TT
F VARIANCE MUMBER
EXISTING STREET R/W ............ FT.
COMP. PLAN ST. R/W ............ FT.
NEW
EJADD
FALTER
REPAIR
RESIDENTIAL
NON-RESIDENTIAl
DEMOLISH
EXCAVATE
EJ OR FILL
-1 PRE -MOVE
F INSP.
El
GAS
NE
s.
RETAINING
WALL
PENCE
........ . x .......... Ft.)
SPN ML
YES
[] YES
PLAN
PLAN
M
[EREhLAIL
NUMBER OF
DWELLING
UNITS
TYPE OF
*=9
1
S
Plan Check No .................
BUILDING
PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
PENCE
SIGN
tRETAINING
WALL
N
SWIMMIN2="
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge th&Lt I have read this application; that the In-
formation given Is 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-
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 Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Parmit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be oom-
p3pqd In six months.)
�(GbIATURE (OWNER Oft AGENT) DATE SIGNED
INSPECTION
IEPARTMENT
CITY OF
EDMONDS
NOTEIAPPlicant Subject to Plan Check Fee
PR 6-1101
This I -emit covers work to be done on private property ONIY.
Any construction on the pubtle domain (curbs, sidewalks, drl%-ew&yo,
marquees, etc.) win require separate permission.
DEFICIENCY THIS PROPERTY
............ B"T.
Valuation
STREET IMPROV]
[] YES [3 NO
RESM
Fee
No.
I 1'�_809
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.
SIGNATunE
7o
Jul
r f
pppppppp
I r
I P I
I LI
I d
.01
RECORD OF INSPECTIONS�
Date Passed
Foundation
1 4
e d I I
Plumbing.(Partial)
+ I
(Rough)
Frame
Furnace & Fuel Lines
r d
Final
Y
I d I
kr r r
r. r r 1 6 C4
'Ir
:+
!"RECOMOF INSPECTIONS
1. + I T I I r
I r 'r:
D d
ate Passe
r r
r Drainage, e r 4
Sewen
Parking
1# r"
La n'ds'ca'p'ing,
Fire Dept,