710306.pdfi
BUILDING DEPARTMENT
PERMIT APPLICATION
NAM (OR NAME OF 8 ESS)
a ADD SS
le i
or
s
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m
W
a
Applicant Fill
Inside Heavy Lines
_7
RESIDENTIAL
—1
GAS
LINE
NEWI
E
NON-RESIDENTIAL
SIGN
❑ ADD
RETLL AINING
ElDEMOLISH
El
WA
ElALTER
EXAVATEl OROFILL E
❑
FENCEx
Ft.)
..........
❑ REPAIR
❑
PRE-MOVEEl
SWIM
POOL
IUMBER OF STORIES
NUMBER OF
DWELLING
I
UNITS
)N KRULL mAr 14U.; PERMIT -� 0306
NUMBER
LESS
%3
5 -IQ
❑ YES ❑ NO
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
FIRE ZONE I TYPE OF
❑ YES ❑ NO
_
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
tRETAINING
WALL
N
ISWIMMING
POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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 lawn regu-
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be c 2j ILLd I_n ninety dgys; MOVE AN BUILDINGS shall be com-
NOTE: t PIicant Subject to Plait Check Fee
This Permit covers work to he done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, Plc.) will require separate permission.
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY TKE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 11-1107
❑ YES ❑ NO
CITY OF EDNIONDS. LOCAL SAL
Valuation I Fee
APPLICATION APPROVAL
No.
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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