730100.pdfBUILDING DEPARTMENT
PERMIT APPLICATION
23—
NEW
ADD
ALTER
REPAIR
q
RESIDENTIAL
NON-RESIDENTIAL
DEMOLISH
EXCAVATE
OR FILL
PRE -MOVE
n
INSP.
DWELLING
UNITS
L
Applicant Fill
Inside Heavy Lines
I;]
777 O
GAS
LINE
SIGN
RETAINING
WALL
❑
PENCE
Ft.)
(-1
swim
I t
POOL
L/4011J
PERMIT
NUMBER 7300100
105,11
1 W."1
LEGAL LOT VARIANCE OR CONDITIONAL USE
❑ YES O NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP, PLAN ST, R/W ............PT. ............FT.
REMARKS
FIRE ZONE TYPE
OF CONSTRUCTION STREET IMPROVED
(❑YES ENO
SPECIAL INSPECTOR
13 YES NO
REQUIRED
(OCCUPANCY GROUP
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS, LOCAL SALES.TAX
SHOULD BE CODED 31.04,
M REARKS
70
Plan Check No. ..... ............
BUILDING
PLUMBING
HEAT a: GAS LINE
FENCE
SIGN
RETAINING WALL
ISWIMMING POOL
DEMOLITION
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 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 shoal be com.
pleted In six months.)
NOTE: Applicant Subject to Plan Check Fee
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, 00-avalks, driveways,
marquees, etc.) will require separate ( !salon,
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
Pn 6-1107
No
I wa 1
APPLICATION APPROVAL
This application is not a permit unt
signed by the Building Official or his Dep
uty; and fees are paid, and receipt is ac
knowledged in pppce provided
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