700259.pdf0
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BUILDING DEPARTMENT I Applicant Fin
PERMIT APPLICATION I Inside Ifeavy Lines
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t
RESIDENTIAL _1 GAS
El NEW r LINE
ElADD NON-RESIDENTIAL F� SIGN
RETAINING
EJ DEMOLISH WALL
ALTER EXCAVATE I'
.PNCE
OR PILL LAI
REPAIR PRE -MOVE SWIM,
El INSP. n POOL
DWELLING
UNITS
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-
lzed agent Of the owner. 1 agree to Comply with city and state laws regu.
latinif construction; and In doing the work authorized thereby, no Person
will be employed In Violation Of the Labor Code of ins Slats Of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be Completed In ninety days; MOVED -IN BUILDINGS shall be com.
Pleted In six months.)
NOTE: Applicant Subject to Plan Check Fee
whim Permit covers work to be done on private —Property ONLY.
Any construction 04 the Public domain (curbs, mldewalks, driveways,
marquees, Otc.) WHI require separate permission.
Is —
1k
PERMIT
NUMBER 700259
ACK BEAR YARF—SETBACIC
VACANT SITE
0 YES [3 NO
MA VAiMM—C—ENUMBER
EXISTING STREET R/W ....... .... FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ........... F-r.
REMARK . ............ IV.
[3 YES 0 NO
Plan Check No.
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
4�;r 15
13 YES 13 NO
Fee
TOTAL AMOUNT DUE
ATTENTION APPLICATION APPROVAL
TIUS PERMIT
AUTHOIUZEa This application Is not a permit until
ONLY THE signed by the Building Official or his Dep.
WORK NOTED uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
INSPECTION IBM
DEPARTMENT
CITY OF
EDMONDS DATE
PR 6-1107 go
FILE
BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICK Inside Heavy Lines
NAME (OR NAME OF BUSINESS)
_1 / /'_ .- I ';' J I � . .. / I k
0
04
Z
Z r
NEW
E] RESIDENTIAL
GAS
LINE
ADD
NON-RESIDENTIAL
0
SIGN
DEMOLISH
RETAINING
WALL
ElALTER
EXCAVATE
PENCE
E]
OR FILL
(Y jj4r.`r/ Ft.)
REPAIR
1:1
PRE -MOVE
swim
INSP.
POOL
IUMBER OF STORIES
NUMBEtt OF
DWELLING
UNITS
.h
I hereby ackdowledgalthat� I'* ji�'Wa� bbs application; that the in-
formation given is correct; and that I ax%thq:jowner, or the duly author-
Ized agent of tha'awner. I agree to comply'with city and state taws regu-
lating construction; and In doing the work authorized thereby, no parson
will be employed In violation of the Labor Code of the State of Washington
relating to Workman's Compensation Insurance.
NOTE: WtMif Lim"it W6- Ytir')j�xlcapt DEMOLITIONS which
shall be completed In ninety days; DIOVED-IN BUILDINGS shall be com-
Plated Jn,six.months.)
NOTE: Appli"nt Subject, to TW Check Fee
This Permit covers work to be don.e_on1Prk-j4jo Property ONLY.
Any construction on the public domain (curbs. sidewalks, driveways,
_nUtrQuats,.etc.) will require sepirstaijermlaslon.
A
POSTED ON KROLL MAP.-TJO.-
PERMIT
NUMBER
700259
JOB ADDRESS
x C�
A
TIDE YARD SETBACK
STREET SETBACK
REAR YARD SETBACK
USE ZONE
LOT A.REA
VACANT SITS
[3 YES 13 NO
HiEiGRT
BUILDING AREA
VARIANCE NUMBER
PLOT PLAN APPROVED
STREET H/W
EXISTING STREET R/W ... ........ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ FT.
1FE-MARKS
0 YES 13 NO
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
f
71
STREET IMPROVED
YES 13 No
APPLICATION APPROVAL
This application is not a permit until.
signed by the Building Official or Ids Dep.
Uty; and fees are paid, and receipt Is ac-
knowledged in Space provided.
INSPECTOR
m