700447.pdfBUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION inside Ileavy Lines
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NUMBER OF
DWELLING
UNITS
POSTED ON KROLL MAP NO.: PERMIT
NUMBER 700447
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J013 ADDRESS Tx�
SIDE YARD SETIFACK STREET SETBACK nEAR YARD SETH
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UkiNG'STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ Pr. ............ Tr.
0 YES
0 YES
Valuation I Fee
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No.
Ca 2-1 414=( el Plan Check No .....................
BUILDING
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PROPOSED USE PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE
PENCE
SIGN
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RETAINING WALL
SWIMMING POOL
DEMOLITION
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PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the In- TOTAL AMOUNT DUE 0 2
formation given in correct; and that I am the owner, or the duly UULnW-
ized agent of the owner. I agree to comply with city and state lawn regu- ATTENTION APPLICATION APPROVAL
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 TIUS PERMIT This application is not a permit until
relating to Workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
NOTE: Permit Limit Otte Yetir (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- knowledged in space provided.
pleted in six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED INSPECTION DIRECTOR'S SIGNATU
DEPARTMENT
lr"-- CITY OF
NOTE: Applicant Subject to Plait Check Fce EDMONDS DATE P1 q�
rR 0-1107
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways, MLE
marquees, etc.) will require separate permission.