700505.pdfa
BUILDING DEPARTMENT
u PERMIT APPLICATION
., I NAME (OR NAME OF BUSINESS)
MAILING ADDRESS
CITY TEL
FarA�OuvaS
NAME
00).1 too — Tel. t Lo
CITY TEL
Applicant Fill
Inside Heavy Lines
10
NO.; PERMIT
NUMBER
)NE NUMBER EXISTING STREET R/W ..tF...FT. DEFICIENCY THIS PROPERTY 1
COMP, PLAN ST, R/W .40..rr,
10 REMARKS
Driveway slopes not to exceed those
I
indicated on Standard Drawing #103.
iacnpuon of Property tanaw Below or AttacnLour (;oples) /�,- w � a
32 &ITTEPACOTW'S LVb'AI TYPE COIN—EN�E�CCTT110N
se7o w6le.
RESIDENTIAL ❑ GAS LINE ❑ YES
R PLAN
•
NON-RESIDENTIAL ❑ SIGN
❑ ADD RETAINING REMA)
❑ DEMOLISH ❑ WALL
❑ ALTER EXCAVATE FENCE
❑ OR FILL ❑ (..........z_....... Ft.)
❑ REPAIR PRE -MOVE SWIM ^
INSP. I { POOL
' I ,.�mor+n yr a„co I awmnrn V
2 DWELLING
UNITS
t
N
I hereby acknowledge that I have read this application; that the in-
formation given 1s 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 Washington
relating to Workmen's Compensation Insurance,
NOTE: Permit Limit One Y (Except DEMOLITIONS which
shall be compJeted In ninety days; D-IN BUILDINGS shall be com-
pleted !n aonlwr A
NOTE: Applicant Subject to Plan Check Fee
This Pervalt covers work to be done, on private property ONLY.
Any constructlon on the public domain (curbs, sidewalks, drlveways,
marqueess etc.) will require separate permission.
Plan Check No, ........ ......
»...
L1t)silat.I.
LI�yliJTVIKir
HEAT k GAS LINE
FENCE
SIGN
RETAINING WALL
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION APPLICATION APPROVAL j
THIS PERMIT This application is not a permit until
ONLYHEs Osigned by the Building Official or his De
xLY TTHEP-
moons NOTED uty; and fees are paid, and receipt is ac-
knowledged in space provided,
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR d-1107
c7—I)
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