700432.pdf7
I
BUILDING DEPARTMENT ApplIcant Fill
PERMIT APPLICATION Inside 11cavy Lines
LJJ I
04 ADDRESS
&In In
SaWrE LICENSE NUDIJJ�11
"3 -0 /- 05�5- /
Z
or
rl__10�
RESIDENTIAL
__1
I
GAS
LINE
E] NEW
NON-RESIDENTIAL
SIGN
U_ADD
El
RETAINING
WALL
0
F1ALTER
DEMOLISH
EXCAVATE
PENCE
F� OR FILL
F1
( .......... x .......... Ft.)
E] REPAIR
PRE -MOVE
INSP.
El
SWIM
POOL
IUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
W4
PERMIT
NUMBER
— 7Z
EET SETBA(
X -e--- "'
REAR RD
VACANT SITI!
[J YES
KISTING-STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ FT. —
C] YES
Plan Check No .....................
Z
BUILDING
PROPOSED USE
PLUMBING
HEAT & GAS LINE
PLOT PLAN (Indicate Building setbacks, abutting streets)
PENCE
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
U NT
TOTAL AMOUNT DUE
TOT AL A I 0
t I In-
he a
h
I hereby acknowledge that I have read this application; that the in-
uthor_
formation given Is correct; and that I am the owner, or the duly author-
u'y a
I we go_
a re
ized agent of the owner. I agree to comply with city and state laws regu.
10
ATTENTION
A T T F N T
0
0 p n
er3o
lating construction; and In doing the work authorized thereby, no person
as
I W hington
will be employed In violation of the Labor Code of the State of Washington
tMII
P El I
TIUS PERMIT
T In
relating to Workman's Compensation Insurance.
I
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
Jbecom-
ONLY TILE
N
I
WORIE NOTED
A
shall be completed In ninety days; MOVED-XN BUILDINGS shall co
pleted In six months.)
3:71OURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
co
CI �ya r
CITY OF
EDNIONDS
NOTE: Applicant Subject to Plan Check Fee
PR 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.
I
STREET IMPROVEL
0 YES a -woo_
Valuation I Fee
APPLICATION APPROVAL
No.
This application Is not a permit until
signed by the Building Off Icial or his Dep-
uty; and fees are paid, and receipt is ac-
lmowledged in Space provided.
t I
FILE
1
1 14
... ..... .... f,II I r fII d I . o� f,fI. 1. .1 111 1
If
If
If
If
fIII 'I.' f I
df,' 1 0
OL 4
If I
If
A 40�
`If
If
It . I I. I. . . .4,0 fj . . . I
If
IN, I $
44 -PI
d
A
4 fl I I
If
IL
fI,
If
. . . I . . . . I .
4r 'If
If
4 4 1 1 1 . . . I . I I
4 %If I
If I
1 .4
01
, L %
I If
E `ORD OF INSPECTIONS
U
Date Passed
07
Foundation
v
J". Plumbing (Partial)
I IMI I
(Rouph)
0 � aAo
Frame
POW
------ Furnace & Fuel Lines
.1. 1.11 1 1. 1.,- Ifinal I.
Is! 11... Z4 I . dfr Cf, 11 If I I I II 1 11 I� I t 4
f If
If
RECOR OF'MPE.CTIONS,
I Ir
`��:Da'�e-Nsseb
I r
'Drainage
t p�
Sewer
I I I I I I 1 —1% 'LI I. Parking,I,
—.4 p4 .
4 Landscaping
P4 I I
FI
141 1 1. 1 1
Id fire. Dept.k
1 1 1114