710298.pdfING DEPARTMENT I Applicant Fill
IIT , APPLICATION Inside Heavy Lines
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NEWRESIDENTIAL
I M
❑
GAS
LINE
NON-RESIDENTIAL
❑
SIGN
ADD
NINE
❑
DEMOLISH
WALL
E
CE
ALTER
❑
OROFILL
ElFEN..x
Ft.)
12 REPAIR
I l
1 l
PRE -MOVE
INSP.
^
� `POOL
..........
swim
POOL
DWELLING
UNITS
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 Biala 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 mopths.)
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curb@, sidewalks, driveways,
marquees, etc.) will require separate permission.
110,M H
f,
C..
A" NO.: PERMIT
I NUMBER. 710298
'KI STREET BETDACK REAR YARD SETBACK
U O
LOT AREA I VACANT SITE 1
13 YES Id W NO x
I BUILDING AREA VARIANCE MBER �
EXI8TING STREET R/W ............FT- DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
S
Ja�c(-g-T:
FIRE Z� I TYPH OF NST Uj3ON kSTREET EIMPROVED
�OCCUPANCYBP
BP IAL INSPECTOR QUIRED
IAL INSPECTOR
❑ YEB�NO
GROUP
THIS SITE IS LOCATED IN
I THIS SITE IS LOCATED IN
PLAN CHECKS 13 `_ l CITY OF EDMONDS. LOCAL
NIJJ TAX SHOULD BE CODED 31
REMARKS
03F.,u2U
— M F—(?—AF 4 c
Valuation I Fee
Plan Check No........
BUILDING
PLUMBING 11
HEAT & GAB LINE G4:
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
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IT 53, 001
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ATTENTION
APPLICATION APPROVAL
THIS PERMIT
This application is not a permit until
AUTHORIZES
signed by the Building Official or his Dep-ONLY
'
TILE
WORK NOTED
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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INSPECTION
I
DIRECTQQQ
SIGN
DEPARTMENT..
CITY OF
J
DATE
EDMONDB
PR d-1107
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