700130.pdfPOSTED ON KROLL MAP NO.: PERMIT
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BUILDING DEPARTMENT
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Applicant Fill
NUMBER
PERMIT APPLICATION
Inside Heavy Lines
JOB ADDRE88
NAME (OR NAME 010 BUSINESS)
SIDE YARD BOT13ACII
STREET SETBACK
REAR YARD SETBACK
MAILING ADDRESS
USE ZONE
LOT A.REA
VACANT 131TE
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—CITY _�TELEFHONB
NUMBER—
YES No
HEIGHT
BUILDING AIWA
VARIANCE NUMBER
04
A17
ADDRESS
CITY
STATE LICENSE NUMBER
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L al Description of Property (Show Bi
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NON-RESIDENTIAL
SIGN
0 ADD
F1DEMOLISH
F-1
RETAINING
WALL
0
EXCAVATE
PENCE
ALTER
0
OR FILL
El
( x Ft.)
REPAIR
PnE-MOVE
........ . ...... ...
SWIM
POOL
INSP.
iUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ . FT.
REMARKS
0 IES 0 NO
CH-W&I
Plan Check No ....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this application: that the In-
formation given In correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and slats 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 Washlngtc-n
relating to Workman's cororensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; BIOVED-XN BUILDINGS shall be com-
pleted In six months.)
NOTE: Applicant Subject to Plan Check Fee
This Permit covers we 'k to be done on private pruperty ONLY.
0
.Any construction an the public domain (curbs. sidewalks, drivewxym,
marqums, etc.) will require separate permission.
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
I
go
Valuation
*�V.Iuws
Fee
9_�, 11
APPLICAVON APPROVAL
This application Is not a permit until
eigned by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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