700350.pdfPOSTED ON KROLL MAP NO.: PERMIT
NUMBER 700390
BUILDING DEPARTMENT 7APpHeant Fin I %_
�j - ; "c:t Tines
FPERMIT APPLICATION' Inside Heavy Lines JOB ADDIIE13S
NAIM (OR
4 '�,DJWAIF OF BUSINESS) 7 SIDE YARD SETBACK STREET SETBACK RRA R YARD I
T, 7-e:::� F/- a I I
Z
rj
W
A
USE ZONE— LOT AREA VACANT ITE
YES 13 No Z
LEPHON HEIGHT BUILDING AREA VARIANUM NUMBEIr...
&A-7797J
ki I —
TELEPHONE NUMBER
I
STREET R/W
EXISTING STREET R/W
............ FT.
DEFICIENCY THIS PROPERTY
k*%, I
COMP. PLAN ST. R/W
............ 77.
............ 17.
REMARKS
,'ATE LICENSE
NUMBER CITY LICENSE NUMBER
of Property (Show Below or Attach Four Copies)
AS
El RESIDENTIAL GINE
El L
LLNON-RESIDENTIAj [:] SIGN
RETAINING
DEMOLISH E] WALL
EXCAVATE FENCE
El OR FILL El ( .......... x .......... Ft.)
IR PRE -MOVE SWIM
INSP. POOL
NUMBER OF
DWELLING
UNITS
REMARKS
TYPE CONNECTION VERIFIED BY
PERC. TEST PERMIT NUMBER
REMARK9--p se� W
V
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
0 YES
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP XNO
C] YES NO
FLAN —CHECKED BY
REMARKS
agal Denc.lxion
NEW
rADD
ALTER
REPt
TUMBER OFSTORIES
4ATURE 01'
WORK 0 BE DUNE
Plan Check No .....................
Valuation
Fee
Receipt No,
BUILDING
?ROPOSED
SE
(Indicate Building setbacks, abutting streets)
tRETAINING
N
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
PLOT PLAI,
TOTAL AMOUNT DUE
T'
I hereby
a In
acknowledge that I have read this application; that the In-
formation given
or
Is correct: and that I am the owner, or the duly author-
'h
lzed agent of
a
the owner. I agree to comply with city and state laws regu-
gu
ATTENTION
lating construction:
and in doing the work authorized thereby, no person
will be employed
,jernon
In violation of the Labor Coda of the State of Washington
'tort
r
THIS PERMIT
relating to V
orkmen's Compensation Insurance.
AUTHORIZES
NOTE: F
rmit- Limit One Year (Except DEMOLITION9 which
ONLY THE
WORK NOTED
shall be com
leted In ninety days; MOVED -IN BUILDINGS shall be com.
plated In six
nonths.)
lIGNATURE
L)
OWNER Oft AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
NOTE:
Applicant Subject to Plan Check Fee
rR 6-1107
This Perinit covers vrork to be done an private property ONLY.
Any const�uctlon on the public domain (curbs, aldewalks. driveways,
marquees, etc.) will rMulra separate permlsidon.
I Q-0 � 15-6,05
APPLICATION 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-
lmowledged in space provided.
FILE