700228.pdfBUILDING DEPARTMEN I Applicant FLU
PERMIT APPLICATION Inside Heavy Lines
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NEW
RESIDENTIAL
GAS
LINE
NON-RESIDENTIAL
SIGN
RETAINING
LjN
WALL
DEMOLISH
ALTER
EXCAVATE
OR FILL
FENCE
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.......... ..........
REPAIR
PRE -MOVE
INSP.
swill
POOL
FUN-113ER OF STORIES
NUMBER OF
DWELLING
UNITS
ON KROLL MAP No.: PERMIT
NUMBER 700228
DRESS
io%4- BACK
CK STREET sETBA X REAR YARD SET
I
.ARD SETBA I
;ONE LOT AREA SITE
YES Z
NO
ISE
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K R
I MLnTNn AREA I VARIANCE NUA
i;�—Bl�FNG'STRZET R/W ............ FT. DEFICIENCY TUIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ FT.
_W 1 -� 1�-j I [] YES NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
0 YES -%(NO I
REMARKS
`R�J()e - Nveauamc 1�%Z1!i.CAVJC4 'ro
giEst if LIS.-COZ64-, fmce!s
puyroc
L) Put r-T.
Plan Check No .....................
BUILDING
PLUMBING
BEAT & GAS LINE
FENCE
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE-MOVS INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin 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- ATTENTION
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 TIUS PERMIT
relating to Workmen's Compensation Insurance, AUTHORIZES
ONLY THE
NOTE: Pe t Limit One Year (Except DEMOLITIONS which WORK NOTED
nety days; MOVED -IN BUILDINGS shall be com.
shall be e �fp.1ated In ni
pleted SIX moon.)
ON IURE (0 VNER Oil AGE DATE ONED INSPECTION
DEPARTMENT
CITY OF
N&E: Applicant Subject to Plan Check- Fee EDMONDS
PH 6-1107
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
C9
m
Valuation Fee Receipt No.
FA�Wja
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
FILE
. ..... - - - - - - -
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tT4.
OF INSPECTIONS
MPRD .
Date Patsta
E20 AJ`4
PlurjiNpg�(Parft�
(Rough);
Frame
AJ6 AJ 67
Furnace�'&- FLieltines'
Final,
RECORD OF INSPECTION
Date Passed,_ -
Drainage
Sewer,
Parking
,�qndscaping
Fire' De't
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