700405.pdf9
POSTED ON KROLL MAP NO.: PERMIT
BUILDING DEPARTMENT ApplIcant F111 NUMBER
DCDUIT kPD1 WATI M I Inside Heavy Lin JOB.ADDRESS 44L
NAME (Oft-N*rl�
,r IFA 1/A_' Z a /
t
ADDRESS
q 9e 77 72V.-
CITY TELEPHUNN NUMBER
I 45Z —3 797it
or
700405
REAR YARD SETBACK
VAG LNT SITE
[3 YES 0 NO
VARIANCE NUMBER
EXISTING'STREET R/W ............ FT- DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT- ............ IT.
ZONE
GAS (j YES NO
NEW Z RESIDENTIAL E LINE PLAN CHECKED BY
NON-RESIDENTIAL r SIGN
RETAINING REM S
DEMOLISH WALL
ALTER EXCAVATE FENCE SA jy�
0 on FILL ( .......... x ..........
REPAIR [:1 PRE -MOVE swim
INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
Pion Check No ................ .....
BUILDING
PROPOSED USE I
0
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
FENCE
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE.MOVF INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given to 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-
ATT14CNTION
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's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEHOLITIONH which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com.
PI lyd in six months.)
TURE (OWNI I OR G�NT) D4LYE SIGN D
"01
INSPECTION
00011, 0(_7
DEPARTMENT
1103
7,
CITY OF
EDMONDS
i;'IINOTE: Apprrt�l?lit $1111ect to Platt Chcch Fce
PH 6-1107
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
STREET IMPROVED
[] YES [3 NO
V)
I
On
Valuation I Fee I Receipt No.
I
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-
Imowledged in space provided.
". t�7 �
FILE
Drainage
sewer
Parking
Landscaping
Fire Dept.