710457.pdfI
BUILDING DEPARTMENT I Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
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NEW
RESIDENTIALI
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GAS
LINE
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SIGN
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/U ADD
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DEMOLISH
ElNON-RESIDENTIAL
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WALL
FENCEx
ALTER
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OROFIIAL
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Ft.)
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El REPAIR
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INSP.
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POOL
NUMBER OF STORIES
NUMBER OF
DWELLING
I
UNITS
POSTED ON KROLL MAP NO.: PERMIT -7
INUMBER
ADDRESS
ao919
E Y RD SETBACK I STREET SETBACK„
i 1045 ,
REAR YARD SET4IACK 1
VACANT SITE
� YES NO
VARIANCE IRUMBER i
EXISTING'STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............ FT.
C7
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THIS SITE IS LOCATED IN THE
REMARKS UTY OF EDMONDS. LOCAL SALE
TAX SHOULD BE CODED Al.na_
Plan Check No .....................
BUILDING
PLUMBING
HEAT do GAS LINE
Wks, abutting streets)
tRETAINING
N
ISWIMMING
FENCE
SIGN
WALL
POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
OTAL AMOUNT DUE
I hereby acknowledge that I have read this application; tha-
formation given Is correct; and that I am the owner, or the dul-
ized agent of the owner. I agree to comply with city and slate la-
ATTENTION
lating construction; and in doing the work authorized thereby, n
will be employed in violation of the Labor Code of the state of W
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
jth
NOTE: Permit Limit One Year (Except DEMOLITIONh
ONLY THE
WORK NOTED
shall be completed In ninety days: MOVED -IN BUILDINGS shall-
pleted in six months.)
NAT (OWNER R
DATE 81GINSPECTION-DEPARTMENT
CITY OF
ED51ONDS
ors:4 pu nt Subj to P Check Fee
PR 0-1107
This Peftit-coveh work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
..... I Fee
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1 *1•a0 V44aI
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.
FILE
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(..' I RECORD OF INSPECTIONS
1,.
Date Passed
Foundation
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_.,... Iumbing (Partial) ?�
(Rough)
Frame >:
a &Fuel Lin
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es_,_—y
Final
RECORD OF INSPECTIONS,
Date Passed
Drainage
i ,..Sewer,
I Parking
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-.-,
Landscaping
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Fire Dept* {
14