700109.pdf----- -- ----- . . .....
POSTED ON KROLL MAP NO.: PERMIT -7
NUMBER 100109
ITMENT I I
BUILDING DEPA Applicant Fill
Inside Heavy Lines JU13 ADDRESS
PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
SIDE YARD SETBACK STREET BET13ACK REAR SETBACK
�PA1_ V�
USE ZONE LOT AREA V GANT SITE
��C -7 0-2- W Z
CITY NUMBER Ej YES El NO
E_�AKAO HEIGHT BUILDING AREA VARIANCE NUIIRPR
NAME
e�s(<�kA W aE�� v PLOT PLAN APPROVED
STREET R/W
CITY NUMBER EXISTING STREET RIW ............ FT. DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R/W ............ FT.
�SEAlTI-E- Wm Ll-�,S:7 e, REUARK13
NAM
ADDREB13 Z
N
M
CHECKED BY
TELEPHONE NUMBER
CITY
1:2 73 METER SIZE SERVICE SIZE
STATE JAUNribill NUMBER CENSE NUMBER CLEARANCE CHECKED BY
Legal Description Of Property (Show Below or Attach Four Copies) REMARKS
Tf4C-- C-- I ot::i I (n)l= 7B E KA I/?- c3r— TYPE CONNECTION VERIFIED BY
-R'L-/N;7 C)P (EA-ES—k PERMIT NUMBER
PERC. TEST ul
A<'_R 5-27>
REMARKS w
tD
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
I [] YES 13 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
GAS YES NO
'RESIDENTIAL
NEW LINE PLAN CHECKED BY
1-1 NON-RESIDENTIAL SIGN
0 ADD RETAINING REMARKS
0 DEMOLISH WALL
ALTER EXCAVATE FENCE 60w�.
OR FULL ( ........ . x .......... Ft.)
SWIM
REPAIR INSP. POOL P-MPfS M050f RZ-) !�JFSMMD Td
EJ PRr_mO"
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE Valuation Fee -Receipt No.
Plan Check No .....................
BUILDING
-PROPOSED USE
PLUM33ING
PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE
FENCE
SIGN
tRETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR rILL
I hereby acknowledge that I have read this application; that the In. TOTAL AMOUNT DUE
formation given is correct; and that I am the owner, or the duly author.
Ized agent nt the owner. I agree to comply with city and state laws regu. ATI!ENTION APPLICATION APPROVAL
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 This application Is not a permit until
relating to Workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com. knowledged in space provided.
pleted in six months.) 10 1
q SIGNED INSPECTION
-R—ONAT RE OF GENT) )�/� DLRECTOR'S SIGNATU,8n_A_
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6.1107
This Permit covers work to be done On Private Property ONLY.
Any construction on the public domain (curbs$ sidewalks, driveways, FILE
marquees, etc.) win require GOP&MtO Pern-Jgslm-
m
j4
70
7-6 L44atx
AM- t=.20 4) A J 10 4) 4-) k-ft
61xQe-7' P44AJ
APO
L RECORD OF INSPECTIONS
Date Passed'
Foundation At4—,?-
Plumbing (Partial)
(Rough) ..
Frame
Furnace & Fuel Lines
Final
e,4t
4:
-too-
seo
RECORD OF, INSPECTIONS
Date Passed
Drainage
Sewer
C
Rarking
Fite' Dd