700393.pdfBUILUINU utrARCIMCNI ApplicantFill
Inside Heavy Lines
PERMIT APPLICATION
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NUB
MAILING ADDH
71-o
101_'_ I TELEPHONE —NUMBER
POSTED ON KROLL M" NO.: PERMIT
I NUMBER 700393
'�_o a -
[3 YES [] NO
ADDRE 38
STREET R/W
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
CITY TELEPHONE NUMBER COMP. PLAN ST. R/W ............ FT- ............
REMARKS
N
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Z
04 _WD-DRESS N
/ 1 TELEPHONE NUM ER CKED BY
CITY L
e- MrTF_R SIZE SERVICE SIZE CLEARANCE ICHECKED BY
4;�� NUMB R
STATE LICENSE NUMBER CITY LICENZ34
72- -L- ) & �L -�> -(� (4- � I REMARKS
Legal Description of Property (Show Below or Attach Four Copies)
TYPE CONNECTION VERIFIED BY
0 PERC. TEST PERMIT NUMBER
U
REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
[3 YES 0 NO
SPECIAL INSPECTOR REQUIR-ED OCCUPANCY GROUP
GAS 0 YES [:] NO
NEW EJ RESIDENTIAL LINE PLAN CHECKED BY
1 1:1 NON-RESIDENTIAL M SIGN
DRETAINING REMARKS
1:1 DEMOLISH WALL
ElALTER EXCAVATE PENCE
1:1 OR FILL ( .......... x ..... FFt.
ElREPAIR PRE -MOVE SWIM
INSP. NUMBER OF 0 POOL
DWELLING
UNITS
NATURE OF WORK TO BE DONE Valuation Fee Recelpt No.
Plan Check No .....................
BUILDI G
NG
-f-R-0-POSED USE
PLUMBING
PLOT PLAN (Ind _331111ding setbacks, abutting streets) HEAT & GAS LINE
to
0 FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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-
ATTENTION
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
THIS PERMIT
relating to Workmen'a Compensation Insurance.
AUTHOFUZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIM
WORIC NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six monthdp
81 OR A T) DATE 8
TURE (O"ICR
INSPECTION
DEPARTMENT
'�G
CITY OF
EDAIONDS
NOTE: Applicant Subject to Plats Check Fee
I
PR 0-1107
This Ilemit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
ramrqueem, etc.) will require separate permission.
I Y'. 0 0
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or Ills Dep-
uty; and fees are paid, and receipt is ac-
Itnowledged in space provided.
FILE
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INSPECTIONS
RECORD OF
Date Passed 6
Foundation
4 1 1 1
Plumbing (Partial)
(Rough)
AVOW it DRY
Kj Frame
4e Furnace Fuel Line
0
4 1 19 1 . -1. 1 11 1 1 9 0 — III to I 1 '9 . I 1 .1 1 9 1 9 1 Mali
RECORD Oft INSPECTIONS
Date Passed+.::,
Drainage 4
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SewerdL :k
Parking
1 41,
1, +1 1 1 19 1 1 — .
UndscapIng
Fire
Dept,
4 1 1 ro, 1z'q I IL I I �j It I I tj I I I I