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Plan Check N. ........ _...........
BUILDING
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ized agent of the owner. I agree to comply with city and state law. raga-
ATTENTION
Ialing wustruetion; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
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AUTHORIZES
E P A R T M E NT
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WORK NOTED
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PERMIT APPLICATI®N
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NAME (OR NAMH OS 6UB1NES8)
v construellon on the public domain (..be. sidewalks, driveways,
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REMARKS Driveway slopes not to exceed those
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APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
Plan Check N. ........ _...........
BUILDING
I hereby acknowledge that I have read thls application; that the In-
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PROPOSED USE
1�(J�(If M ,� PLUMBING
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PLOT PLAN (Indicate Building setbacks, abutting elicete) HEAT &OAS LINE
FENCE
SIGN
tRETAINING WALL
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
ized agent of the owner. I agree to comply with city and state law. raga-
ATTENTION
Ialing wustruetion; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Runners.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
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APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thls application; that the In-
formation given Ie correct; and that I am the owner, or, the duly author-
ized agent of the owner. I agree to comply with city and state law. raga-
ATTENTION
Ialing wustruetion; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Runners.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY HE
WORK NOTED
.ball be completed inuiae y day.; MOVED -IN BUHMINOS .lull be com-
pietcd In .Ix month..)
310 A U (OWNER O 36 D
]NBPECTION
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DEPARTMENT
CITY OF
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EDMONDS
NOTE: Applicant Sub a to Plan Check Fee
PR g-1107
Chis Permit curers work to be done on private property ONLY.
v construellon on the public domain (..be. sidewalks, driveways,
mauees, etc.) will require separate permission.
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APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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BUILDING DEPARYIIAENY Applicant Fill
PERMIT APPLICATION Itulde Heavy 31,11108
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ADDRESS
NAME
(OR NAME OF BUSINESS)
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STAT LICENSE NUMBER
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REMARKS
Legal Description of Property (BROW Below
or Attach Four Cople.)
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TYPE CONNECTION
VERIFIED BY
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
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SPECIAL INBPECCT�_OA AEOUIRED OCCUPANCY GROUP
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LINE
YES
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IN THE CITY
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PLAN CHECKED THIS SITE 15 LOCATED
/rOF EDMONDS. LOCALSALES TAX
N-REBIDENTIAL SIGN
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0 ADDElRETAINING
REMARKS
DEMOLISH FWALLENCE
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REPAIR INSP. POOL
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NUM ER OF+RIES NUMBER OF
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FENCE
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BION
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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I hereby acknowledge that I have [led this application: that the 1n.
farne.tlon given Is correct; and that I ant the owner, or the duly euthor-
teed agent of the owner. I agree to complY with City end state Iaws raga-
ATTENTION
APPLICATION APPROVAL
latl.g conetructloa; cod Ia doing the work authorl:ad thereby, ao Deno.
will be employed In violation of the Labor Code of the State of WOahington
THIS PERMIT
This application is not a permit until
relattag to WorkmeWs Campensatloa Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (E.c.pt DEMOLITIONS Which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In bluely days: MOVED -IN BUILDINGS .hall be cone.
knowledged in space provided.
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BIGNATU (OWNER OR AGEr'/l')
DATE 816NED
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INSPECTION
DEPARTMENT
DIRE TOA'8 SIGNATURE 1,
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CITY OF
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DATE
NOTE: Applicant Subject to Plan Check Fee
EDhfONDB
PR a-Ildv
This Permit coven Nark to be done on private property ONLY.
Any eo..tractlot o. the public decimal. (curb., sidewalks, drlvewaY.,
INSPECTOR
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mOreuee.. etc.) wN Mule. several. per 0.1cn.
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RECORD OF INSPECTIONS
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Date Passed
Foundation}-/o
Plumbing (Partial)
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Frame
Furnace & Fuel Lines
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