700396.pdfPOSTED ON KROLL MAP NO.; PERMIT
Applicant Fill /i q J I NUMBER
Inside Heavy Idnes JOB ADDRESS j e / _
6"
�A6 a.iv_�srs0
(JAAAda l Frt WA, I f'/16 /y yD
77y 922/
0
or
NEW too RESIDENTIAL ❑ GAS
LINE
NON-RESIDENTIAL ❑ SIGN
ADD ❑❑ RETAINING
DEMOLISH
ALTER ❑ OR FILL FENCE
FILL EXCAVATE (..._x_....... Ft')
REPAIR ❑ PRE-NP, O BWIL
7UMHER OF STORIES NUMBER OF /
DWELLING
I UNITS
I . '
-E
EXISTING STREET R/W .._........ FT, DEFICIENCY THIS PROPERTY j
COMP. PLAN ST, R/W ............FT. ..........=0 O �. •- � .
REMARKS
Driveway Slopes not to exceed those indicate
on Standard Drawing #103.
to,
FIRE ZONE I TYPE OF CONSTRUCTION
SPECIAL INSPECTOR REQUIRED OCCUPAI
❑ YES ❑L' d ( ,
PLAN CHECKED BY
REM
(:::74XR6/L.70 40 �7s7R-ed
u/V&17� /AmaA 7'/1/S
Valuation
Plan Check No. ........... _... ...
BUILDING 4 4
PLUMBING
HEAT & OAS LINE
FENCE
SIGN
RETAINING WALL
N
I 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-
Ized 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 DEMOLITIONS which
shall tut completed In nicety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
®R/
NOTE: Applicant Subject to Plan Check
s Permit coven
work to
be done
on private property ONLY,
construction an
the public
domain
(curbs,
sidewalks, driveways,
marquees,
etc.) will
require
separate
permission.
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR g-1107
MIM
29:o Ot
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-
3lnowledged in space provided.
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