710485.pdfBUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION amide Heavy Lines
1 NA (OR NAME OF BUSINESS)
or
s
�j
RESIDENTIAL
❑
GAB
LINE
i Y 1
NEW
NON-RESIDENTIAL
❑
SIGN
ADD
RETAINING
_
❑
LL
DEMOLISH
EXCAVATE
PENCE
ALTER
❑
❑
Ft.)
REPAIR
❑
PRE -MOVE
INSP.
.x..........
swim
POOL
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
I
[AP NO.: PERMIT
D NUMBER
007
71048-
I
YES ❑ NO
EXISTING STREET R/W ...r.���ILipp...FT. DEFICIENCY�+ 'T�HIS PROPERTY
COUP. PLAN ST. R/W .a Z.FT. ...0...FT.
REMARX"Driveway slopes not to exceed those
Sly I I II AJ,A.A" b2� U PC t R7 0
Spa -
❑,YES ❑ NO
❑ YES ❑ No
CITY OF EDMONDS. LOCAL
uN7/& tJT/,�/ Tiles BfrV
l"Dfn
Plan Check No .....................
BUILDING
PLUMBING
HEAT k GAS LINE
tRETAINING
iSWIMMING
FENCE
SIGN
WALL
POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE '
hereby
I hereby acknowledge that I have read this application; that the in -
given Is correct; and that I am the owner, or the duly author-
lzed agent of the owner. I agree to comply with city and state lawn regu-
ATTENTION
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
TIDS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
THE
ONLY NOTED
WORN NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
ptete In mix months.)
B ATURE (OWNER OR 0 T) DATE SIGNED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR a-uoT
. This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curb@, sidewalks, dr►veways$
marquees, etc.) will require separate permission.
Fee'' Receipt No.
1a1/-1 4e.33/
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-
knowledged in space provided.
-7,
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RECORD" OF INSPECTIONS !
t.,.
s Z.� Date
��% / L; Passed
_ /
Foundation
(R, . 9
Plumbing (Pa Ci._ _ 7� %•
# (Rough) Lq"!7 7! (��. { t `
e
Frame
Fuel Lines. t .�
Furnace & I
' rev Final
#
�,.,,�y REINSPECTIONS.
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^, �^1,�� - RECORD
D Dat <P ssed,:
� OF,
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I. ..:Drainage -------- .
( Sewer
P.
f Parking
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Landscaping _. k, !
Fire Dept.
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