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710544.pdf
BUILDING DEPARTMENT I Applicant Fill >PRIT APPLICATION InJs(do Heavy Lines �VrAXM `(OR NAJAJuOF BUSINESS) z- 0 w� a e' zJ U a xl -2tu sw Saws to © NEW ADD ALTER ElREPAIR Sa m C_. or RESIDENTIAL ❑ OAS LINE NON-RESIDENTIAL ❑ SIGN RETAINING DEMOLISH WALL ❑EXCAVATE OR FILL El FENCE (.........x.......... Ft.) PRE -MOVE INSP. swim POOL I �~ DWELLING UNITS � i f/buss I drI POSTED ON KROLL MAP NO.: PERMIT i'• 4 A NUMBER 710 JC+ tr JOB ADDRESS 81DII YARD SETBACK STREET SETBACK REAR YARD SETBACI< I hereby acknowledge that I have read this application; that the In- formation given to 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- 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 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.) IIGNATURE (OWNER OR AGENTA DATE SIGNED aQ 7 La1(-/�L-7I NOTE: Applicant Subject to Plan Check Fee This Permit coven work to be done on private property ONLY. Any construction on the public domain (earbs, sidewalks, driveways, marquees, etc.) will require separate permission. YES 0 NO sa�sar.a non � EXISTING STREET R/W la p� ... FT- DEFICIENCY THIS PROPERTY COMP. PLAN ST. It/W .iL D..FT. ..... 0..FT. _ REMARKS ))r1VCiay sbpes not to e:;ceed those indicated on Standard llrQj'rinv t 103 a V 0 p YES ❑ NO 0 YES NO I L� � I PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY CITY OF Fnhtnnlne t 9 AI SA, REMARKS ES SHOULD BE CODED 31.04. Plan Check No ..................... Valuation Fee Receipt No. BUILDING PLUMBING S-A ! q , b o HEAT A GAS LINE FENCE SIGN RETAINING WALL SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL AMOUNT DUE I I O C I ATTENTION APPLICATION APPROVAL TINS PERMIT This application is not a permit until AUTHORIZES signed by the Building Official or his Dep- ONLY THE uty; and fees are paid, and receipt is ac- WORK NOTED knowledged in space provided. INSPECTION DIRECTO ' SIGNA RE DEPARTMENT CITY OF DATE ^_ 71 EDMONDS PR 8-1107 FILE F i i I I i