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POSTED ON KROLL MAP NO.: PERMIT ? 10007
E p,AIR T M E N T Applicant Fill NUMBER j
' 614�6A I®N Inside Hcavy Lines JOB ADDRE8e
1• SIDE YA,ltp SKTHAICK I STREET a 'rBACK REAR YAI�U SETBACK
t J US a I LOT AREA I VACANT SITE
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0 YES VO
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�tr%ELEPHONE `N'U[M�BERf�(
IiGI6 AEBER
I IIUILDIN6 AREA I I' lA—70
IMBER
Property (Show Below or ARIWLL aeua ..vp, c.y
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�iESIDENTIAL
❑
INE
NEW
NON-RESIDENTIAL
❑
SIGN
ADD
RETAINING
ElDEMOLISH
❑
W
ALTER
❑
D
EXCAVATE
FENCEx
Ft.)
OR
( ..........
REPAIR
❑ PRE -MOVE
El
SWIM
POOL
VUTIBER OF STORIES
NUMBER OF
DWELLING
UNITS
VL
EXISTING STREET R/W ............FT.
COMP. PLAN ST. R/W ............FT.
DEFICIENCY THIS PROPERTY
FIRE 7 TYPE OF CON RUCTION 8T 'ET IMPROVED
�I I YES 13 NO
SPZOIAL INSPECTOW REQUIRED !OCCUPANCY ROUP•
(] YES NO 1
PLAN CHh`C1fY:D BY
REMARKS�®
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.2 45/ 8/
Plan Check No...........
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
tRETAINING
WALL
N
ISWIMMING
POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DI
I hereby acknowledge that I have read this 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
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted Inpix, months.)
I1GNA 011 (OWNER OR AGE T) DATE SIGNED INSPECTION
DEPARTMENT
CITY OF
EDNIONDS
NOTE: Applicant Suhjec to Plan Check Fee Pit 6.1107
This Permit covers work to he delta on private property ONLY.
Any construction on the public domain (curbs, sidewalks, drlvewaYs,
marquees, etc.) will require separate permission.
Valuation
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Fee I Receipt No.
FGMM
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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-
knowledged in space provided.
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