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POSTED ON KROLL MAP NO.: I PERMIT
NUMBER 710124
BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION Insldo Heavy Linos JOB ADORERS
NAME ! i
SIDE YARD SETBACKI STREET SETBACK (REAR YARD SETBACK 4
MAILING DRESS
USE ONE LOT AREA VACANT BITE i
CITY Q / {' TELEPHONE NUM(B�ER� / I I ❑ YES ❑ NO
J1 k j (-Z I / �.- r �t7X ? HEIGHT 1 BUILDING AREA I VARIANCE NUMBER
M
4
O
or
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NEW
u RESIDENTIAL
ADD
❑
NON-RESIDENTIAL
❑
DEMOLISH
ALTER
❑
ORCFI LATE
REPAIR
^l
I
PRE -MOVE
INBP.
DWELLING
UNITS
s
❑GAB
LINE
SIGN
RETAINING
WALL
FEfI pp
SWIM
POOL
t
I
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 com.
pleted In six months.) A
NOTE: Ap fWcant'Subject to Plan Check
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.
PLOT PLAN APPROVED I f
t �
STREET R/W -
EXISTING STREET R FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............FT.
REMARKS W I
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f '
PERMIT NUMBER a�1
G �
m
i
TYPE OF CONSTRUCTION STREET IMPROVED
❑ YES ❑ NO I �
❑ YES ❑ NO
PLAN CHECKED BY
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Receipt No.
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Plan Check No .....................
Valuation
Fee
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
1
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
APPLICATION APPROVAL i
THIS PERMIT
This application is not a permit until
AUTHORIZES
Signed by the Building Official or his Dep-
ONLY THE
WORK NOTED
t is ac-
uty� and fees are paid, and receipt
knowledged in apace provided.
INSPECTION DIRE '011'8 BIONATURE/�-
DEPARTMENT
CITY OF � �liLvly 1` �rC lf?LL
EDMONDS nwTh n
PR a -lion
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. .. `..:_ RECORD: OF INSPECTIONS:
Date Passed
Foundation
,!Partial)
Plumbing
1�
I (Rough)
s Fra me
r
Furnace & Fuel tines
Final
RECORD OF- INSPECTIONS .. ...... __ X:?
Datto
e Passed
Drainage
,, rY ,
I ';a Sewer
Parking
Landscaping
D _ .. .
Fire ept.
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