710581.pdfi
MONK POSTED ON KROL MAP NU.;
BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICAI WIRI Ineldo heavy LtneH JOD ADDnE/d�H
NAME (OR NAME OF BUSINESS) I R Q t"J S CJ
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PERMIT
NUMBER
LACK r REAR
DQ YES
STREET 8/W %N
EXI8TIN6 STREET R/vorb/`i2L�"I•• DEFICIENCY THIS PROPERTY
COMP. PLAN BT. R/RSUJ,�ICiFr. •••••'^T•!•FT•
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Driveway slopes not tor; ,e;aeed thocs
or
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NEW
RESIDENTIAL11:1
GAS
LINE
❑
NON-RESIDENTIAL
❑
SIGN
ADD
WAIL RETAININE
❑
DEMOLISH
ALTER ❑
TE
On FILL
❑
PENCE
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REPAIR ❑
PRE -swim
INBP.
POOL
4UMBER OF STORIES
NUMBER OF
DWELLING
/
UNITS
13f� i I I�
IECTION I VERIFIED- 131 �
FIRE
I
Im
TYPE OFTRUCTIPN
N
EET IMPROVED
ZES [] NO
SPECIAL INSPECTOR REQUIRED
C] YES )!(NO
I OCCUPANiY GROUP
•
PLAN CHECKS
BY
THIS SITE IS LOCATED IN THE
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REMARKS
TAX Si i0l�i.D
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Plan Check No .....................
SUILDIN6
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PROPOSED USE
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PLUMHIN6 (�
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PLOT PLAN (Indlcata Building setbacks, abutting streets)
HEAT h 6A8 LINE /...ns
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FENCE
SIGN
RETAINING WALL
N
I
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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-
lzed agent of the owner. I agree to comply with city and elate laws regu•
ATTENTION
lating construction; and in doing the work authorized thereby, no person
will be employed In violation of We Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Imurance.
AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which
WORK NOTED
shall be completed In ninety days; b10VED-IN BUILDINGS shall be com-
pleted In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
tT%
l ;Z, ' t
OF
CITY
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-I107
This Permit covers work to be done on private property ONLY.
Any construction oa the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
i Fee Receipt No.
f
3 -Z5a1 & 4�
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and Pees are paid, and receipt is ac-
knowledged in apace provided.
FILE
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