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POSTED ON KROLL MAP NO.: PERMIT 10���
BUILDING DEPARTMENT Applicant Fill NUMBER J _ f
PERMIT APPLICATION Inside Heavy Linos JUB ADD^^fi(E,/BB tti S i
NAME Ryo `' � C q
I„ BIDE YARD SETBACK( STREET SETBACK IR.EAR YARD SETBACK ,J
MA NG ADDRESS .•- r// G
USE ZONE LOT AREA VACANT SITE
CI D V _ �- TE 7EP�NE N �B}rR ❑ z i R-S �/ I I YES ❑ NO
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�• ` D HEIGHT I BUILDING AREA I VARIANCE NUMBER
NAME
FF PLOT PLAN APPROVED
O t
p7 ADDRESS
F,y STREET R/w
Oy EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
c CITY TELEPHONE NUMBER
c COMP. PLAN 8T. R/R' ............FT. ............ FT. dy !
REMARKS W(,I
` NAME
t7 �
43
O ADDRESS W
CHECKED BY
TELEPHONE NUMBER
U 8T E LICENSE NUMBER CITY LICENSE NUMBER METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED BY
W
REMARKS
Legal Description of Property (show Below or Attach Four Copies)
TYPE CONNECTION (VERIFIED BY -
Z 1
fy PERC. TEST PERMIT NUMBERpl I
A Ikaj
91 REMARKS GO
0 FIRE ZONE (TYPE OF CONSTRUCTION STREET IMPROVED
❑ YES ❑ NO
SPECIAL INSPECTOR REQUIREDOCCUPANCY GROUP
GAB ❑ YES ❑ NO , I rr
YJ RESIDENTIAL ❑ LINE PLAN CHECKED BY J D IIV 1 RE
NEW lT❑\ CI•rY OF EDMONDS. LOCAL SALES
❑
NON-RESIDENTIAL SIGN
❑ ADD RETAINING REMARKS
❑ DEMOLISH WAIT' Q
ALTER ❑ EXCAVATE FENCE I v �P
OR FILL (.......... x.......... Ft.)
EJ REPAIR O PRE -MOVE SWIM �\ MCA IOa I
INBP. POOL l II
NUMBER OF STORIES I NUMBER OF -`
i
DWELLING I
UNITS
NATURE OF WORK TO BE DONE Valuation Fee Receipt No. I
// _ i
S�G�dC-.��, Plan Check No ........ ............ r
x
p BUILDING
PROPOSED USE PLUMBING !
q � i
W
a PLOT PLAN (Indicate Buliding setbacks, shutting streets) HEAT &GA8 LINE
j FENCE
•s I
SIGN
RETAINING WALL
— I l
I SWIMMING POOL
i
DEMOLITION
PRE -MOVE INSPECTION i
EXCAVATION OR FILL I f
_F TOTAL AMOUNT DUE �o9L•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- ATTENTION APPLICATION APPROVAL I 1
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington TIUS PERMIT This application is not a permit until `
relating to Workmen's Compensation Insurance. AUTHORIZES Signed by the Building Official or his Dep- 1
ofvLY THE ut and fees are aid, and receipt is ac-
Pe IItI it One Year (Except DEMOLITIONS which WORK NOTED y' p
hall b com sled In nely day!; MOVED -IN BUILDINGS shall be com- knowledged in space provided.
piste In efx mcaths.) :
816 ATURE OWN i OR AGENT) DATE PONE INSPECTION D CTOR'S SIGNA UREn
i w DEPARTMENT
cy
EDMONDS
NOTE: Applicant Subject to Plan beck Fee PR 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalk!, driveways, FILE
marquees, etc.) will require separate permission.
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( t : RECORD 01: INSPECTIONS
Date Passed
Foundation
Plumbing (Partial)
(Rough)
Frame
Furnace &Fuel Linesi
Final
RECORD OF, INSPECTIONS '
fl
r Date Passed
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Drainage
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Sewer
` parkin
g
I ,
Landscaping
Fire Dept
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