710589.pdfr
POSTEI
BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION
Inside Heavy Lines ros AE
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REMA
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NAME
-
Ill
ADDRESS
CITY
TELEPHONE NUMBER
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STATE LICENSE NUMBER
I OFT—Y—L-1—CE—N—S—E—WYMBER 2
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C
,is
PERMIT
NUMBER
t I Ci589
YES ❑ NO
DEFICIENCY THIS PROPERTY
Driveway slopes not to 1. exceed those
_ RE2CAii7C8
TO fm �°�-
TYPE CONNECTION
SeuJ61z
RESIDENTIAL
GAS
LINE
®E]
NEW
❑
NON-RESIDENTIAL
SIGN
ADD
RETAINING
❑
❑
ALL
ALTER
DEMOLISH
EXAVAT❑ E
NCE
OROFILL
(�........ . x.......... Ft.)
REPAIR
n
PRE -MOVE
INSP.
El
SWIM
POOL
DWELLING
UNITS
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-
ized agent of the owner. I agree to comply with city and stale laws regu-
lating construction; and In doing the work authorised 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.)
'1-26-71
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY -
Any construction on the public domain (curbs, eidewallu, driveways,
marquees, etc.) will require separate permission-
DYES ❑ NO
SPECIAL INSPECTOR REQULKED I occu HOU
YES jW.NO
PLAN CHECKED BY
THIS SITE 13 LCC.';TED IN THE
TAX SHOULD BE CODED 31.04.
Q� r//0,1-.4Z To tom' 7 o G z,s z-
Fee
PlanCheck No .....................
No.
BUILDING
PLUMBING
HEAT h'O*B'
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
APPLICATION APPROVAL
THIS PERMIT
This application is not a permit until
AUTHORIZES
signed by the Building Official or his Dep-
WORB'. NOTED
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION
DLRECT01VIf SIGN
DEPARTMENT
CITY OF
DATE
�/
EDMONDB
PR 6-1107
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RECORD OF INSPECTI(SN9
Date Passed
Foundation
i t �_ .r r• Plumbing (Partial)
Frame -owl 47
7 �—
Furnace & Fuel line
'
Final
RECe
ORD OF INSpECT0l
Lja.L
' � �Passed • ,
Drainage
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ng
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