710081.pdf1
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POSTED ON KROLL MAP NO.: PERMIT
BUILDING DEPARTMENT Applicant NUMBER
€" .`PERMIT APPLICATION I Inside Heavy Lines IO13 ADDRESS /
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710081
B DO YARD BET13ACK STREET SETBACK REAR YARD SETBA
USE ZONE OT AREA VACANT SITE
HONE NUMBER qS— 12- I YES Cl NO
IIEI HT I BUILDING AREA I ARIANCE NUMBEI
PLOT PLAN APPROVED
STREET R/W �j
'HONE NUMBEIt EXISTING STREET R/W .//!W!10-FT. DEFICIENCY THIS PROPERTY
j COMP. PLAN ST. R/W 4?.P.PT. ..b.FT.
REMARKS
Driveway slopes not to exceed those indic
on Standard Drawin g #103 • j{ p ,@ ill
E
FIRE
NEW
❑ ADD
ALTER
❑ REPAIR
P-Zr
RESIDENTIAL
❑ NON-RESIDENTIAL
El
AS YES
LINE ❑PLAN
SIGN
WAS, NINC REMAI
PENCE
(.x..........Ft.)
swim
POOL
❑
❑
❑ DEMOLISH
❑ ORFILL
❑ INSP.
❑
DUMBER OF STORIES
NUA113ER OF
DWELLING
I
UNITE
TYPE
Plan Check No .....................
BUILDING
PLUMBING
HEAT do GAS LINE
FENCE
SIGN
RETAINING WALL
11—
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that tho 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 elate laws regu-
ATTENTION
lating construction; and In doing the worst authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
TIHB PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
316 URE (OWNS OR AGENT)
DATE SIGNED
INSPECTION
/ s p
/
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Kibject to Plan Check Fee
PH 8-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
0 YES
IOUP
0"r,
Fee
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.
FILE
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