700254.pdf. ... ...... . ..... ........ -------- -- ........... ..... .. ....... .
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BUIL-DING DEIARIMENI I Applicant Fill
PERMIT APPLICATION Inside 11cavy Lines
AME (OR NAME OF BUSINESS)
Z,
MAILING ADDRESS
S,& /6> - -J� C) -1, A&P
CITY
46ZkM&41A0.r ILI C:)/
NAME
b C) WAI&R,
ADDRESS
CITY TELEPEONE NUMBER
014__Nor��
z
or
- i�z_
NEW
PQ RESIDENTIAL I F1
I
GAS
LINE
El
NON-RESIDENTIAL
EJ
SIGN
RETAINING
DEMOLISH
WALL
EXCAVATE
FENCE
ALTER
OR FILL
( x Ft.)
.......... ..........
REPAIR
El
PRE -MOVE
INSP.
SWIM
POOL
NUMBER UF
DWELLING
U
12f-
z
NPROPOSED USE
Cd=
(Indicate Building setbacks
PLOT
I hereby acknowledge that I have read this application; that the In-
formation given Is correct; and that I arn the owner, or the duly author-
lzed 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 DEIMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com.
pleted IrLsix months.)
NOTE: Applicant Subject to Plan Check Fee
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.
�D ON KROLL MAP NO.: PERMIT
NUMBER 700254
:)DRESS
? 1� / o — D 0 -.1
YARD BET13ACK I STREET SETBACK REAR YARD HETIJJ
'7 4 Q :5�
S - ?
0 YES VJ NO
STREETF/W
EXISTING STREET R/W ............ FT. DEFICIENCY TH113 PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ a
REMARKS
KAIM
0 YES
NO
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
[] YES
Valuation I Fee
No.
TOTAL AMOUNT DUE
I I / ;;�7 , I i&z/.q
ATTENTION APPLICATION APPROVAL
THIS PERM11T Tills application is not a permit until
AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ac-
N Imowledged in space provided.
INSPECTION DIRECTOR'S SILINATURE
DEPARTMENT
CITY OF
EDMONDS 1:>ATE��
11,11, 6-1101 6-14)-90
FILE
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RECORD OF INSPECTIONS
Date Passed
Coe
F U
o ndation
Plumbing (Partial)
(Rough)
Frame 4;z
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Furnace.& Fuel Lines..,...
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INSPECTIONS
RECORD OF
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DateLpasS
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Drainage. % L
ed
Sewer 'L L
I 9t P L
L L L Parking
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Landscaping
Fire De