710020.pdfs
1D
UILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
LAME ((/0�
-7d Z
LING ADDRESS., / O
7• 0 USE ZONE
^�— TELEPHONE NUMBLft C I
10 r / 14 M. enl &_ l on I Y 5. 7-3 13 / HEIGHT
PERMIT NUMBE710020
R
1
tom+( .
SETBAOK
REAR YARD SETBACK
2
2-
YES
SITE
NO
!l UMHER
IJO C4&Xj1L!r -rO &IS71AJ4—
r STREET 11/W
TELEPHONE NUMBER EXISTING STREET n/w ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. „
REMARKS
17
�2 6 2
72t / ,6
j(f cl
NEW RESIDENTIAL
GAS
LINE
ADD
NON-RESIDENTIAL
❑
SIGN
DEMOLISH
RETAINING
WALL
ALTER
FENCE
❑
ORCFILAL
❑
PRE -swim
.ac..........Ft.)
REPAIR ❑
INSP.
POOL
VUMBER OF STORIES
NUMBER OF
2
DWELLING
UNITS
t , I
L
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.
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 Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be corn -
Plated In six mouths.)
NOTE: Applicant Subject to Plan Check Fee
•cros rermlt coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marQuees, etc.) will regnire separate permission.
REMARKS W
L�,/ sTI NCB
❑ YES
Plan Check No.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WOnI( NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 0-1107
Valuation
❑ YES
NO
No.
Ir44ft v 16-f v.
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and re^elpt is ac-
knowledged in space provided.
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