700098.pdf7
POSTE ON
KROLL MAP NO.: PERMIT
BUILDING DEPARTMENT
Applicant Fill
NUMBER
00098.
PERMIT APPLICATI ONInside
Ileavy Lines
J013 ADDRESS
. OF BUSINESS)
NAME (Olt NAME
SIDE YARD
SETBACK STREET SETBACK
UbjAlt YARD BET13
0
MA LdNCQ) ADDRES"s
USE ZONE
LOT AREA
VACANT UITN
7450 1vo
4nX,
. T ELEFRUNN 14UMUZin
CITY
YES [3 N
^
HEIGHT
BUILDING AREA
VARIANCE NUMBE
L�
E,
1_4
z
DNEW
ADD
ALTER
REPAIR
or
GAS
RESIDENTIAL LINE
ElNON-RESIDENTIAL SIGN
RETAINING
ElDEMOLISH WALL
EXCAVATE FENCE
OR FILL V ..
PRE -MOVE SWIM
INSP. POOL
DWELLING
UNITS
I hereby acknowledge that 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-
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 DE51OLITIONS which
shall be completed In nicety days; MOVED-ILN BUILDINGS shall be com-
pleted in mix months.)
6?176
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, drivew"s,
marquees, etc.) will require Separate perrulesion.
EXISTING STREET R/W ............ FT.
COMP. PLAN ST. R/W ............ FT.
FIRE ZONE I TYPE OF
[3 YES [] NO
REMARKS
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
THIs rERAUT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
DEFICIENCY THIS PROPERTY
[3 YES [] I -TO
Valuation I Fee
h=1P_JM4k
No.
1:2�0 & bwo
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or bis Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
ram
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