700444.pdf4,
POSTED ON KROLL MAP NO.:
PERMIT
I NUMBER 700444
BUILDING DEPARTMENT Applicant Fill ZZ 12
Inside Heavy Lines JOB ADDRESS
-PERMIT APPLICATION I
NAME I it- 0
SIDE"YICRD SETBACK STREET SETBACK REAM YARD SETBACK
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MAILING ADDRESS .541) V US�RNE LOT AREA VACANT SITE a
CITY I �TELEPHONE NUMBER YES No Z
HEIGHT BUILDING AREA VARIANUE NUMBER
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NAME
T—LOT P1
N ADDRESS
STREET R/W
OCJ EXISTING STREET R/W FT DEFICIEN THIS PROPERTY
CITY TMEPXIUNE NUMBER *65 .... FT.
COUP. PLAN ST. R/W ... IT.
REMARKS
NAME Driveway slopes not to exceed those indicated
Cai,,Ley C r C V. I —
C4 ADDRESS on Standard Drwaing #103. Z
I CUVCKED BY
CITY TELEPHONE NUffBER
'Ilsev 10 /1 METER SIZE SERVICE SIZE CLEARANCE CHECKaDIBY
Q STATE ),ICENSJ:� NUMBER CITY LICENSE NUMBER
REMARKS
Legal Description Of Property (Show 1301OW or AURC11 Four Copies)
7 T_,�-aj> Plu, AIO;L TYPE CONNECTION VERIFIED BY
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6 REMARKS
FIRE Zo
TYPE OF STRU STREET IMPROVED
YES Ej NO
SPECIAL INSPECTOR REQUIRED OCCUPANCYr
GAS E] YES NO
EHD NTIA LINE PLAN CHECKED 13Y
NEW LNON_RESIDELTIJAL SIGN
ADD RETAINING REMARKS
DEMOLISH El WALL
ElALTER EXCAVATE FENCE
1:1 OR FILL ( .......... x .......... Ft.)
REPAIR PRE -MOVE SWIM
1:1 INSP. POOL
NUMTE—ROI? STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE Valuation Fee Receipt No.
Add,Plan Check No .....................
Z
Re -S I Je#) C. BUILDING
PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
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N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE 13 0
I hereby acknowledge that I have read this application: that the In- (5-617.
formation given to correct; and that I am the owner, or tho duly author-
Ized agent of the owner. I agree to comply with city and state laws regu- ATTENTION APPLICATION APPROI
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 This application is not a permit until
relating to Workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep-
ONLY TILE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com- Imowledged in space provided.
pleted In six months.)
SIGNTTURE '(OWNER-UR AGENT) DATE SIGNED IN13PECTION DIRECTOR' 8 NATO
DEPARTMENT
6 CITY OF
EDMONDS DATF_
4
NOTE: Applicant Subject to Plan Chech Fee PR 6-1107 70
Thin Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways. FILE
marquees. etc.) will require separate permission.
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