700369.pdfPOSTED ON KROLL MAP NO.: PERMIT
I NUMBER 700369
BUILDING DEPARTMENT A I
8 PP71111
PERMIT APPLICATION In Ide irt Tines JOB ADDRESS r
- 217th St. S.W
Larry Everett
MAILING ADDRESS
9011 - 217th St. S.W.
_61—TY ILELEPHONE
Edmonds, Wn. 7?4-4797
bi ADDRESS
14
STREET RIW
CITY TELEPHONE NU.11001� EXISTING STREET R/W ............ FT.
I I COMP. PLAN ST. R/W ............ FT.
ri
Z
Q
Gas Applicance Service Inc.
ADDRESS
4242 - 24th West
CITY T LEPHONE NUMBER
Seattle, Washington At. 3-3555
Lot 9
- Add
or
DNEW
RESIDENTIAL
I
R
GAS
LINE
NON-RESIDENTIAL
SIGN
ADD
RETAINING
WALL
DEMOLISH
EXCAVATE
FENCE
ALTER
OR FILL
El
( X Ft.)
REPAIR
El
PRE -MOVE
INSP.
R
.......... ..........
swim
POOL
DWELLING
UNITS
t
N
I
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 atuthor-
Ized agent of the owner. I agree to comply with city and state lawn regu-
lating construction; and in doing the work authorized thereby, no Verson
will be employed In violation of the Labor Code of the State of Washington
relating to Workmenle Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In nix months.)
—70
NOTE: AppficantXbject to Plan Check Fee
This Permit coven work in be done on private property ONLY.
Any construction on the public domain (curbs. sidewalks, driveways,
marquees, etc.) will require separate permission.
[] YES
El NO
DEFICIENCY THIS PROPERTY
............ FT.
I
at
FIRE ZONE TYPE OF CONSTRUCTION
I STREET IMPROVED
[3 YES El NO
SPECIAL INSPECTOR REQUIRED
0 YES 0 NO
OCCUPANCY GROUP
PLAN CHECKED BY
REMARKS
Plan Check No .....................
Valuation
Fee
No.
—Receipt
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOT" AMOUNT DUE
I I 1
�11' .56 '50't" -a (
ATTENTION
APPLICATION APPROVAL
THIS PERMIT
This application is not a permit until
AUTHORIZES
eigned by the Building official or his Dep-
ONLY THE
WORK. NOTED
uty; and fees are paid, and receipt Is ac-
Imowledged in space provided.
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
10 1 L/
FILE
I
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