710487.pdfPOSTED ON KROLL MAP N
' BUILDING DEPARTMENT Applicant I"M
PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS
NAME (OR NAME OF BUSINESS)
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RESIDENTIAL
LINE
NEW
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NON-RESIDENTIAL
❑
SIGN
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❑
DEMOLISH
❑
RETAINING
ALTER
❑
OROFILL E
ElFENCx
Ft.)
..........
REPAIR
I eP.
SWIM
POOL
;UMBER OF STORIES
NUMBER OF
DWELLING
I
UNITS
YARD SETBACK
/D
ZONE
S—/ Z
MET BETH
EXISTING STREET R/W ............FT.
COMP. PLAN ST. R/W ............FT.
❑ YES ❑ NO
PERMIT 7 10487
NUMBER
❑ YES
DEFICIENCY THIS PROPERTY
............FT.
BY
YES ❑ NO
THIS SITE IS LOCATED IN THE
REMARKS CITY OF EDMONDS. LOCAL SALES
TAX SHOULD BE CODED 31.04.
I /
-a Plan Check No .....................
[[[Orrr BUILDING
PROPOSED USE
PLUMBING
U
aPLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & OAS LINE
FENCE
SIGN
RETAINING WALL
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\ I BWIMMIN6 POOL
DEMOLITION
t PRE -MOVE INSPECTION
EXCAVATION OR FILL
�I Y
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin application; that the In-
formation given 1s 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- 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 THIS PERMIT
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
SIGNATURE (OWNER OR AGENT) I DATE SIGNED INSPECTION
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee Pn 6-1I07
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 permission.
Valuation I Fee
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.
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