700373.pdf,�-.BUILDING DEPARTMENT
I I Applicant Fill
Inside Heavy Lines
PERMIT APPLICATIO
NAME (OR 14AME OF BUSINESS)
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61-Ty TELEPHONE NUMBER
Edwclmc�s,
NAME
DRESS
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TELEPHONE NUMBER
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Description of 1-roperty (kinow isajow or ALLAC11 Pour utipica,
7that por. of.tract 33v Edmonds Sea
�58 f0llowe- Beg. A NE eers
tract, the t.p.b. th N89c,42131" W a
1. of 242.0 ft. to then cur of sMd
tract; th S 0*38,4011 w a dis. of 100-10
F
0� th
S. 89o441;7, B a dis of z42.0i it. to
I the E side of said tract: th N 003812011
0 E a dis. of 99.98 ft. more or less to th
-point of beg,
0 NEW
-1
F RESIDENTIAL
I
[:]
GAS
LINE
El
NON-RESIDENTIAL
SIGN
D---
DEMOLISH
RETAINING
WALL
EXCAVATE
PENCE
ALTER
OR FILL
( X Ft.)
REPAIR
PRE -MOVE
INSP.
.......... ..........
swim
POOL
DWELLING
UNITS
PPOPOSED qSE
PLOT PLAN (Indicate Building setb=kS,
23
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I
I hereby acknowledge that I have read this application; that the In-
formation given Is correct; find that I am the owner, or the duly author-
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 person
will be employed in violation of the Labor Code of the State of Washington
relating to Workman'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.)
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NOTE: Applicant Sitbject to Plan Check Fee
ThJs Permit covers work to be done on private property ONLY.
Any construction on ilia public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
NO.: PERMIT
I NUMBER 700373
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9
EXISTING STREET R/W ............ PT.
COMP. PLAN ST. R/W ............ FT.
0 e
13 YES
DEFICIENCY THIS PROPERTY
............ FT.
_44"� 1 1 il 1) 1 [1 YES C!rRO
SPECj,k-L INSP UIRED OCCUPANCY GROUP
YES E; 77�
P LAN CH
��77/,
Receipt No.
Plan Check No.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ZOO
ATTENTION APPLICATION APPROVAL
THIS PERNUT This application Is not a perniif until
AUTHOIUZES signed 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 DIRECTOR'S SIGNATYRS
DEPARTMENT
CITY OF
DJL
EDMONDS
PH 6-1107
FILE
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