700366.pdfr 11
POSTED ON—K—ROLL MAP NO.: PERMIT
700366
BUILDINAG
DEPARTMENT
Applicant Fin
I NUMBER
PERMIT
APPLICATION
Inside Heavy Lines joB
ADDRESS
NAME (OR NAME
-I
".'GDRE
LMA
04
SIDIT YlARD—SET913ACT—R&ETBACK
m4&n YARD SETBA4
M AI G ADDRESS'
USE ZONE
OT AREA
V -CANT SITE
NUMBER
YES [3 NO
Z
ADDRESS I
STREET R/W
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
CITY TELEPHONE NUWB--ER —
COMP. PLAN ST. R/W ............ FT. ............ IT.
RE ARKS
0 NEW
ADD
I�KRESIDENTIAL
1 1:1 NON-RESIDENTIAJ
o
r ]
AS
GLINE
SIGN
RETAINING
WALL
0 YES
PLAN
REMAI
DEMOLISH
FENCE
ALTER
EXCAVATE
OR FILL
( x Ft.)
.......... ..........
REPAIR
PRE -MOVE
INSP.
El
swim
POOL
;UMBER OF STORIES
NUMBER OF
DWELLING
UNITS
1�
[] NO
I I
OF
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
tRETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
I EXCAVATION OR FILL
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 nuthor-
Ized 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 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
This Permit coven work to be done on private property ONLY.
Any coustroction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
TOTAL AMOUNT DUE
AT=NTION
TIUS PERMIT
AUTHOIUZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
Valuation
[] YES 13 NO
Fee I Receipt No.
I I-jq, a C) I (!�� 3- ri-
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.
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