710151.pdfe
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YOSTF:D ON KROLL MAP NO.: PERMIT
BUILDING DEPARTMENT nrpum Applicant NUMBER 7I0I5I
PERMIT APPLICATION I Inside Heavy Linos IOB ADDRESS Z 3 e� — Lj(
NAME ( ,
or
NEW
RESIDENTIAL
LINE
ElNON-RESIDENTIAL
❑
SIGN
ADD
❑
❑
yAET�A,INING
DEMOLISH
ALTER
❑
ORFILL
❑
FENCE
`.x..........Ft.)
a REPAIR
❑
INSP
WIM
OOL
POOL
DWELLING
UNITS
LxFN . T
A0911loo '
(ze-51 potc -f
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 DE51OLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
,2 017
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 separate permission.
I
___ -I0 1 251 z5
USE ZONE 1 LOT AREA VACANT BITE
2.5 — 1 -vl I ❑ YES ❑ NO
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
❑ YES
❑ YES ❑ NO
0
cw p uti.r wc'L w t w: Ul' C_ 1 `1-7 0
Plan Check No .....................
Valuation
Fee
Receipt No.
BUILDING
PLUMBING
HEAT A GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
f
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY TICE
ORK NOTED
WORK
APPLICATION APPROVAL
This application Is not a permit until
Signed by the Building Official or his Dep-
ut and fees are aid and receipt is ac-
3'� p� p
knowledged in space provided.
INSPECTION DIRECTO//jiii SIGN R
DEPARTMENT 3
CITY OF DATE
EDMONDS
PR 6-1107