700217.pdfBUILDING DEPARTMENT Applicant Fl 11 P . OSTED U
!!Mj� Inside Ileavy L.Itnes —joB ADDR�
PERMIT APPLICATION
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ElNEW
ADD
ALTER
REPAIR
RESIDENTIAL
ElNoN-RrSIDE NTIAL
GAS
LINE
SIGN
RETAINING
WALL
FENCE
( .......... x .......... Ft.)
SWIM
POOL
DEMOLISH
EXCAVATE
OR FULL
PRE -MOVE
INSP.
lUB113ER OF STORITS_
NUMBER OF
DWELLING
UNITS
L MAP NO.: PERMIT
NUMBER 700217
S. — / 12,
[3 YES [3 NO
EXISTING I STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ FT.
REMARKS
TYPE OF
0 YES [] NO
REMARKS
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
I
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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 lawn regu-
latIng construction; and In doing the work authorized thereby, no person
ATTENTION
will be employed In violation of the Labor Code of the State of Washington
TIUS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
I
shall be completed In ninety days; BIOVED-IN BUILDINGS shall be com-
pleted ��,six months.)
INSPECTION
DEPARTMENT
CITY OF
3IGNA RE (OWN t ATE SIGNED
—If-719
di6m_
EDMONDS
NOW Appli"nt Subject to Plan Ched, Fee
PR 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marqueesp etcJ will require separate permission,
[] YES [] NO
Valuation Fee
APPLICATION APPROVAL
No.
This application is not a perntit until
signed by the Building Official or his Dep-
uty; and fees fire paid, and receipt is ac-
Imowledged in space provided.
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FILE
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RECORD OF INSPECTIONS
Date Passed
Foundation
..... .. Plumbing (Partial)
L (Rough)
Framz
1. 1
Furnace & Fuel,Llnes
Final-., CIIIIIIIIII 0
I I r
RECORD OF IN�PE
'kA
Date Passed
It
Drainage
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Park
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Lands6a'ping
Fire Dept.