740100.pdfU
BUILDING DEPARTMENT I AppilesntFlll °NE
PERMIT APPLICATION IL/Sldo Heavy Lines �Ga
Anne
— I niZ"]l O
NEW RESIDENTIALIF
LINE
�y NON-RESIDENTIAL RSION
❑ ADD ❑
❑ DEMOLISH WAIS NO
KI
ALTER ❑ ORCAVATFILL E ❑ FEN Cx.......... Fl.)
REPAIR ❑ IN P. O POOL
�UMOER OF STORIES NUMBER OF
DWELLING
UNITS
IATURE OF WORK TO BE DONE -
PA-'YAaP C-_ 1hl I.- lt�l, I
PERMIT
NUMBER 740 i 00
i
FRONT RIDE REAR FRONT RIDE REAR I
0 NO
EXISTIV STREET R/W ............hj. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
0 YES 0 NO
OF
YES 0 NO
411 ce
♦,.P 1—
Pion Check No ......... ...........
A�� '�'��'C'
BUILDING
[y
4 ROP BED USE LV
,
a
PLUMBING
,
�&PLat
Indice Rullllddling aetDncke, abut Bete
HEAT & GAS LINE
-tong
�A
t
PENCE
SIGN
�,r
�[.3_
1JG.
RETAINING WALL
I
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that 1 have eentl this application; that the In.
/ r
formation given Is correct: and that I am the owner• or the duly author-'
Izcd agent of the owner. I agree to comply with city and state lawn rogu-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no ..on
Will be employed In violation of the Labor Code of the Stale of Washington
THIS PERMIT
This application Is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
eigned by the Building Official Or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
WORE NOTED
uty; and fees are paid, and receipt is ac -
,hall be completed In ninety days; MOVED -IN BUILDINGS shall be cam•
knowledged in space provided.
pleted In six months.)
SIGNATURE (OWNERO AGENT) DATE SIGNED
ON
DIRE R'S S1G4ATU
'
DEPARTMENT
l •
7L)/L� f �'
CITY OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
PR 0.1107
_
This Permit covers work to be done on prlvnte property ONLY.
Any c,u,ntructiun ou the nubile dumaln (curb., nld—alh., drlvoway.,
FILE