700464.pdf'BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION Inside Ileavy Lines
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ICENSI
1-11
AB
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6
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E5_ �NEW
E] RESIDENTIAL
GAS
LINE
NON-RESIDENTIAL]
SIGN
RETAINING
WALL
DEMOLISH
ALTER
D
EXCAVATE
El
FENCE
Ft.)
OR FILL
( .......... x ..........
REPAIR
1:1
PRE-711OVE
INSP.
1:3
swill
POOL
4UMBER OF STW�IES
NUM13ER OF
DWELLING
UNITS
G)
CIP
I
PERMIT
NUMBER .700464
�W5�-
SIDE YARD SETBACK S*REET SETBACK REAR ARD SETBACK
10 rn ag, rh '25, M.A.,O.
USE MONE LOT AAWGA VACANT ULT19
'N
PK10'. I I VYES NO
iTn 411W
EXIWNG STREET RIW-.20 FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W�0)FT. 0
REMARKS
Driveway Slopes not to exceed those indicated
on Standard Drawing #103. Z
44 1 _-P ,- 01
0 02�: a A
CONSTRUCTION
0 YES WNO P*
P—LAN CHECKED 13Y
I
REMARKS
Plan Check NO .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin application; that the In-
formation given In 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. ATTENTION
lattng construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Coda of the State of Washington THIS PERMIT
a In
tho
re go
r
erson
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gt
relating to Workmenla Compensation InsuraLnea. AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
ca
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
IG 'A URE (OWNI,��Olt AGENT) ATE SIGNE INSPECTION
/77 D 0 DEPARTMENT
CITY OF
EDMONDS
OTE.---a
Applican Subject to P an
PR 0.1107
This Permit coven work to be done on private �roperty ONLY.--'
Any construction on the public domain (curbs, sidewalks. drivewaYs,
marqueeso etc.) will require separate.parmission.
9M
Valuation Fee Receipt No.
01)
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00
APPLICATION APPROVAL
This application Is not a pernilt until
signed by the Building official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
DIRECTOR SIGNATU E
FILE
0