700059.pdfBoom
POSTED ON KROLL MAP NO.:
PERMIT
NUMBER
1
BUILDING
DEPARTMENT Applicant Fill
100059
PERMIT
APPLICATION Inside Heavy Lines
JOB ADDRE88
NAME NAME OF BUSINESS)
(OR
619.—
"y (�
.91DE YARD SETBACK I STREET
SETBACK IREAR
YARD SETBACK
t
I
A
,n
-71&-S-� OZ� -St
f
r
or Attach Four Col
01 N E W
L_J RESIDENTIAL
1
1:1
NON-RESIDENTIAL
El ADIJ
ElDEMOLISH
ALTER
EXCAVATE
OR FILL
REPAIR
F�
PRE -MOVE
INSP.
DWELLING
UNITS
FGAS
I
LINE
EJSIGN
RETAINING
WALL
EFENCE
( ........ x .......... Ft.)
SWIM
POOL
r
t
N
I
I hereby acknowledge that I have read thin application; that the in-
formation given In correct: and that I arn the Owner. or the duly author-
Ized agent of the owner. I agree to comply with city and stato lawn 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: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
Pleted In six months.)
3IG
NAT,VRE (qyVNER Oft,#GfVT) I IIATE SIG14ED
NOTE: Applicant Subject to Plan Check Fee
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.
USE ZONE LOT AREA VACANT SITE
I 1 0 YES [3 N
I RT1TT,nTNfZ AREA I =VARIANCE !NUAiR N
PLOT PL PPROVED
STREET IF/W
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ . FT. 0
REMARKS
BY
JMBER 94
TYPE OF CONSTRUCTION STREET IMPROVED
I [] YES [:1 140
[:] YES (:] NO
Valuation
I'Ian Check NO .....................
BUILDING
PLUMBING
HEAT & GAS LINE
rrNCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION Olt FILL
Fee
No.
TOTAL AMOUNT DUE
ATTENTION APPLICATION APPROVAL
THIS PERMIT This application Is not a permit until
AUTHORIZES signed by the Building official or his Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION DIRECT
DEPARTMENT
CITY OF
EDMONDS IYA—TE \1
A- — �, 0
PR 6-1107
FILE
...........
A
Lt
RECORD OF INSPECTIONS
Date Passed
-C"mot,
Foundation
�Plumblng (Partial)
I
All;
(Rough)
Frame
Furnace & Fuel Lines -
Final Z�2 76 Ak./
71-
RECORD OF INSPECTIONS
Dat6 Passed
DraInage-:
�Sewer,.,,�,
Parking
',Landscaping
Fire,Dept.