700378.pdfPOSTED ON Rao" MAP No.:
PERMIT
I NUMBER 700378
BUILDING
DEPARTMENT AppUcaant FIR
Lacs
PERMIT
III( Icavy
3
APPLICATION I Inside Heavy Lines
7771_
I
JOB ADDRESS
ex-) -
NAMEOLNAME OF BUSINESS) /
MSIDE YARD SETuAuK I STREET
—
SETBACK REAR YARD SETBACK
Z
P
4
W-v\ .
EXISTING STREET R/W ............ FT.
COUP. PLAN ST. R/W ............ FT.
ZONE
RESIDENTIAL
I
[:]
GAS
L NM
YES
[3 YES
NEW
PLAN
PLAN
NON-RESIDENTIAL
SIGN
ADD
RETAINING
WALL
MAX
M
DEMOLISH
ALTER
EXCAVATE
OR FILL
PEN CE
( .... ..... x . ........ rL.)
[RE
REPAIR
PRE -MOVE
INSP.
swim
POOL
Zjij
qUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
AM
ftrolw.m.
5),
[] YES
11:NO
0:::::
UMBER
DEFICIENCY THIS PROPERTY
Cj YES [3 No
Valuation I Fee
A
—A-f I�LAM Li 0�s
Plan Check NO ................ ...
4 BUILDING
D I
PROPOSED USE
PLUMBING
12
PLOT PLAN (Indicate Building SettIMCILS, abutting streets)
HEAT & GAS LINE
VENCE
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
C)
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-
ized agent of the owner. I agree to comply with city and state laws regu-
ATMNTIO'N
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
be in violation of the Labor Code of the State of Washington
THIS PER311T
This application is not a permit until
will employed
relating to Workman -A Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DE51OLITIONS which
ONI.Y THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
pleted in six months.) INSPECTION
IJAWN SIGNED
SIGNATURE (OWNER OR AGENT) DEPARTMENT
7,
CITY OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan Cbeck Fee
Title Permit cOvers work to be done on privato property ONLY.
on the public domain (curbs, sidewalks, driveways,
PR 6-1107
FILE
ef
Any construction
marquses, tic.) will require sep%MtO permission.
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