700068.pdfBUILDING DEPARTMiNT
PERMIT APPLICATION
Applicant FIU
7
lInside Heavy Lines
VY Lines
POSTED ON KROLL MAP NO.:
PERIII
�B.T
NUM E
'R
700068
JOB ADDRESS
14
NAME (OR NAME OF BUSINESS)
I Ali- Loel e � � J, J� - � I - . 'I- -7V
Sit)].! YARD RIPTHACK. I
STRFET SET13ACIC I
REAR YA
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TELEPILONL NUMBER -
TELEPHONE NUMBER
NEW
L4(frnESIDENTIAL
GAS
LINE
I
El
NoN-nESI
El
17
�""
SIGN
RETAINING
0
WALL
DE161OLISH
EXCAVATE
FENCE
ALTER
E] OR ]FILL
( x Ft.)
REPAIR
PRE -MOVE
1:1
.......... ..........
swim
INSP.
POOL
TUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
I /i
r4r-
t
N
I hereby acknowledge that I have read this application; that the In-
formation given to Correct; and that I am the owner. or the duly author-
Ized agent of the owner. I agree to comply with city and state 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.
N6TE: Permit Limit One Year (Except DE31OLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
1 9
3IONAWURE (OWNER OR A NT DATE SIGNED
NOTE: Applicant Subject to Plan Check Fee
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
nimquees, etc.) will require sepmate permlsolon.
—1 4r I I [] YES 13 NO
EXISTING STREET R/W .......... YT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ F-r. ............ . FT.
REMARKS
CHECKED BY
METER SIZE I SERVICE SIZE I CLLARANCE JCHECKFD BY
REMARM
TYPE CONNECTION VERIFIED BY
PERC. TEST I PERMIT NUMBER
REMARKS
FIRE ZONE I TYPE OF CONSTRUCTION I STREET IMPRO'
-1:u I 1 0 YES 009007
�iPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
0 YES 20ro f
PLAN CHECKED BY
1P$0eQr,rjAJ
A6 7
Plan Check No ....................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
�:P%j "W"kLeW981610
DE31OLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERIMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 0-1107
-ra
c6yPa"Cer barro
Valuation I Fee I Receipt No.
d
APPLICATION APPROVAL
This application is not a pem-dt until
Signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
FILE
f
-71
1. . ___ __ 1
Fire, bept.