700468.pdf111 ... . .....
POSTED
111.111DING DUARTMINT Applicant Fill
PERMIT APPLICATION Inside Heavy Lines -T013 —ADE
1314
NAME
C4 SIDE YJ
MAILING ADDRESS
7, r USE
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94 AD'
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or Attach Four
RESIDENTIAL
0
"AS
LINE
NEW
NON-RESIDENTIALJ
F�
SIGN
14
RETAINING
ElDEMOLISH
0
'WALL
0
EXCAVATE
FENCE
ALTER
OR FILL
( x Ft.)
REPAIR
PRE -MOVE
INSP.
.......... ..........
SWIM
POOL
NUMBER OF
DWELLING
UNITS
PERMIT
NUMBER 700468
A
0 YES [3 NO
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ I - T.
FIRE ZONE I TYPE OF
[3 YES [] NO
REMARKS
Q A tj "f 9LZj Igpi4e., 4 g2rry. Finn Check No .....................
Z
BUILDING
PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE
FENCE
SIGN
tRETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read We application; that the In.
formation given Is correct; and that I am the owner, or the duly author.
Ized agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
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 DEMOLITIONS which
ONLY TRE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com.
pleted In six months.)
IIGNATU E (OWNER OR AGENY41
DATE SIGNED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
1,G'TE: Applicant Subject to Plan Check Fee
PR 6-1107
Title Permit coven work to be done on private property ONLY.
Any crastruction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
0 YES [3 NO
Valuation I Fee
FZ
No.
1 /0, 5-V 1(5 7 113.
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-
luiowledged in space provided.
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RTIOI( BUILDINGTERMIT
WONDS Building Department
is hereb
Appl. No. ..I-�33.— &.0 ..... ,
........... ......... .....
Permit -limit, one year
r made for a permit to construct the following work, in accordance with the accom,
ions. Two sets are submitted herewith for approval.
Off -St
............................................... Parking ......................
...........
..............
Use zone ....
Af.' .9 ....... Fire zone ............................
....... Blk ........................
Addn ......................................
......... A 4,.,*M ........................................... Septic tank .........................................................
y
... ........
.... ........... r. side ........................ 1. side .............................. rear .......... to
Address. .... �OA-7 - - ---- / .. �Tel. No .............................
............................. Address ....... �.; .... ..........
............................ Address ......................
................. Tel. No .............................
.....................................................
........................................................................................ ................................................................................................
........................................................................................... ................................................................................................
A)
T e
h above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this
work.
Signed Owner/Agent6LL/ .64.-'1 .... ....... Address ............................................ Date ... ................
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ap-
proved plans and specifications, and Building Department notations thereon.
/Z? .. cr P enit fee ......... ............. Reed. by ................... o ....................................
Valuation .
Building Department, By ..................... 0 ......... .................. Date ..... .....................
This Permit does not cover Plumbing, Sewer or Electrical installations.