710302.pdf71
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POSTED ON KROLL MAP NO.:
PERMIT
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BUILDING DEPARTMENT
AppLtuntFlil
PERMIT APPLICATION
InBlde Heavy Lines
JOB ADDRESS
4-1
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NAMII ( )
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81DE YARD SETBACK
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STREET SETBACK
REAR YARD SETBACK
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USE ZONE
LOT A
VACANTSITE
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CIIT�Y
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HEIGHT
I HUiLDINO AREA
VARIANCE N MBER101
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STREET R/W
[ONENUMBEREXISTING STREET R/W .c.. P'T.
?✓—D / G OUP. PLAN ST. R/W 5.
RE.Q.FT.
Dri
M ADDRESS
6 on
CITY ( TELEPHONE NUMBER
............ .....�................�... nrmv r.rn>,.ruar.+. w,rtvnF!R Mg
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or
NEW
RESIDENTIAL
LINE
❑
NON-RESIDENTIAL
❑
ADD
8I6N
❑AINING
L]
WAI..L
DEMOLISH
EXCAVATE
FENCE
ALTER
❑
❑
sFt.)
REPAIR
El
PRE -MOVE
INSP.
..........
SWIM
POOL
DWELLING
Res'i1 z.4, UNITS
C� PROPOSED USE
PLOT PLAN (Indicate Building s
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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-
Ited agent of the owner. I agree to comply with city and state laws regu-
lating construction; and in doing the work authorised 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.)
NOTE: Applicant Subject to Plan Check Fee
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permiselon.
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❑ YES MR NO
Plan Check No....
BUILDING
PLUMBING
HEAT & OAS LINE
FENCE
SIGN
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 a-11o7
DEFICIENCY THIS PROPERTY
,
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YES p NO
OCCUPANCY ORUP 1
CITY OF EDNiONDS. LOCAL S1
Valuation
e' I /7/66"04
r/�/, Sd 161�K
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-
Imowledged in space provided.
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_ RECORD OF INSPECTIONS t.:.;. , +
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I Date Passed
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Foundation
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E iA�. Plumbing (Part
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Roguh
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Frame .
es /Q ;
Furnace Fuel
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t ;RECORD Ol" INSPECTIOIVS
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p Date Passed5 j
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Drainage
Sealer. + ` } ° t r a,rt t `' .rat It,
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\•,�\J j F. - ,t i er 1, r `
W ;. ,iit I, f
parking
_._.. Landscaping xy
" Fire Dept.
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