700472.pdf114
BUILDING DEPARTMENT. I Applicant Fill
PERMIT APPLICATION Inside Heavy Lines JuB j
NAME (OR 'NAME OF BUSINESS) I
b ri 0 C' I A-'s Al 5: 2- SIDE
MAILING ADDRESS —1
-7 2e '2- U
CITY I �TELEPHONE NUMBER
/.a p -s 7;1' 7 Z HEIC
Z
U
scription of Property (snaw below or ALEacn j
L o -I— �;_
6 / 15 a P, /,+ V/
RESIDENTIAL
M
GAS
LINE
NEW
NON-RESIDENTIAL
SIGN
RETAINING
0
WALL
DEMOLISH
ElALTER
EXCAVATE
PENCE
Ft.)
OR FILL
( .......... x ..........
E]
REPAIR PRE -MOVE
INSP.
swim
POOL
ES NUMBER OF
DWELLING
UNITS
.IATURE OF WORK TO BE DONE
potm (�' av
PERMIT
NUMBER
� t 7 :Pl- � V 'X 4
WK STREET SETBACK
:/ 1 .1 -T ( M'��
700472
�, J aj.
,&R YARD SETBACK
A V.)
�CANT SITE
YES Nt�o
Z
11
,RIANCE rVMBER
EXISTING- STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ FT.
REMARKS
[j YES 0 NO
REMARKS
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this application: that the In-
formation given In 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-
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of WaAhlogton
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DE51OLITIONS which
shalt be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted in six months.)
_/_Z� I C/� so�
Applicant Stibiect to Platt Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require sep"ato permission.
TOTAL AMOUNT DUE
ATMNT]ION
TIUS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
BY
0 YES 0 NO
Valuation I Fee
CIO
APPLICATION APPROVAL
No.
This application Is not a permit until
vigned by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILE
Sn
IMF
I'A
I I
If 1 1111 41 If ffI, If I
I
If
If
If
IT
fi` it' 1 4 1 1 1 I-1p.
4,
rp f I j
If f
'If .11 .1111
If
I'S
if
If - -
id W., *I if .. I. . . . I If 'i I I
iff
4, 4 iS
I ;d
I I If fI I I I I I I 1 4 1
I . . . I I I . . I . I A
'Iff. -fIp I I I - - -- - -
If I
If I
41 v
If I I I
If I If
If. L,
If Tj
If I I
I I I I
If
14
If - If
jr
If
Ifff I II0, "iii� I- I I Ife I I . I . . . I I . % I, If
I., If
fI,
If I I I I
I,� If I!
if
RECORD OF INSPECTIONS
vl Date Passed
f If." 11� < 11! Foundation
4 1.: 1 Plumbing (Partial)
(Rou6h)
I "f�'. r%' If
Frame
Furnace & Fuel Lines
Final
I If- i-. z I f- 11 P. I I I
14" A . 'I if 0 If I t"i I "L
I L
I I L pe
RECORD OF, INSPECTIONS If
If Date Passed I
f I I I . I L L 4 , if I
Drainage
Af
Sewer
4 Pa ii�king
Iq
If - -If I andscaping
f '.,Fire Dept
If '11(, 1. 1 1 1
If+
II-VIIIL. .f... I- Aif.. ......