710139.pdfi
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BUILDING DEPARTMENT I Applicant Flu
PERMIT APPLICATION Inside Heavy Lines
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REPAIR PRE -MOVE swim
INSP. POOL
DWELLING
UNITS
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M I PRO O ED USE
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a PLOT PLAN (Indlcnta Building setbacks, abuttl
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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 Coda 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 nix months.)
2•Ll-&a-Zest d
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require ceparate permission.
D ON KiROLL,M-/AP NO.: MJMBER
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710139
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)DRESS
YARD SETBACK STREET SETBACK REAR YARD uETIIA1
I ", ;'d .Z �-' Yr) , -
a s 1 h ily
L NE{
LOT AREA VACANT
SITE
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YES ❑ NO _
PLOT PLAN APPROVED /i(/# , 'Z, g ' 7 O U(��L37C� t'- 1 OO/l�
�� • C (4V 45" 04c) 99
STREET R/W sp
EXISTING STREET R/W .� FT. DEFICIENCY HI8 PROPERTY
COMP PLAN ST R/W �41cr. Fr. C
REMARKS I
Driveway slopes not to exceed those indicated
n
on Standard Drawinl? #103. w
FIRE Z9,3W I TYP1OFSTVON I aYESr imrtt NO D11-2ZSPECIAL INSPECTOR REQUIRED OCCU. �T OR UP
0 YES NO I S /
PLAN CHECKED BY Ai
REMARKS
Plan Check No......
BUILDING
PLUMBING
HEAT A GAS LINE
FENCE
BIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 0-1107
Valuation
0
No.
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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