700380.pdfPOSTED ON KROLL MAP NO.:
PERMIT
70C
BUILDING DEPARTMENT
Applicant FLU
I NUMBER
PERMIT APPLICATION
Inside Heavy L.11nes
JOB ADDRESS
Th _10
SIbE �tARD SETBACK I
STREET
BETBAUAt RE&R I YARE
0
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Z
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El
RESIDENTIAL
D
GAS
LINE
ElNEW
F-1
NON-RESIDENTIAL
SIGN
ADD
RETAINING
DEMOLISH
WALL
ALTER
A
EXCAVATE
FENCE
OR FULL
( .......... x .......... Ft.)
REPAIR
1:1
PRE -MOVE
SWI311
INSP.
POOL
;UbIBER OF STORIES
NUMBER OP
DWELLING
UNITS
13 YES
El NO
EXISTING'STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. . ............ IT.
OW4;j�
FIRE ZONE I TYPE OF
[3 YES [3 NO
REMARKS
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
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 author-
lzed 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 DE51OLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be econ-
pleted in six months.)
-E
NOTE: Applicant Zbject to Plait Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.� will require separate pernilmelon.
TOTAL AMOUNT DUE
ATTE, NTION
TIUS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 0-1107
valuation
C] YES El NO
No.
IA. o 0 1 1
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-
knowledged in space provided.
C�
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