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PER IT APPLICATI N
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Legal Description of Properly (Show Below
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❑ DEMOLISH
WALL ^'IAG
ALTER
EXCAVATE
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(CHECKED BY
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METER SIZE
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NUMBER OF STORIES NUMBER OF
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DWELLING
12
UNITS
NA TIJj*Nj ORKTO DE j)ONE
REMA1iH8
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7
5K
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6 STREET R/W ............FT. DEFICIENCY THIS PROPERTY
ISST
COMP. PLAN ST. R/W ............FT. ............FT,
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REMARKS1
top USE
PLUMBING
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x
W
O
aPLOT
(CHECKED BY
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METER SIZE
SERVICE S1ZE
CLEARANCE
CHECKED HY
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12
FENCE
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REMA1iH8
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TYPE CONNECTION
VERIFIED BY
WALL
PERC. TEST
PERMIT NUMBER
N
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REMARKS
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FIRE ZONEITYPE OF CONSTRUC'}'ION EET T IMPR VED
ST
ES 0 NO
PRE -MOVE INSPECTION
SPECIAL INSPECTOR REQUIRED
OCCUPANCY G OUP
EXCAVATION OR FILL
F' -Z
0 YES ZNO
-
PLAN CIIEcxE ¢Y THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
OF
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TOTAL A51OUNT DUE
i SHOULD BE CODED 31.04.
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REMARKS
1 hereby acknowledge that I have read this application; that the In-
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form¢tlon given le correct; and that I am the owner, or the duly author.
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BUILDING
top USE
PLUMBING
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aPLOT
PLAN (Indicate Building setback,, ¢bull[.. street.)
HEAT A GAS LINE
tl
FENCE
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
�1
TOTAL A51OUNT DUE
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1 hereby acknowledge that I have read this application; that the In-
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form¢tlon given le correct; and that I am the owner, or the duly author.
- -
.cdagent of the owner. I agree to comply with city and stale law, 112-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorlled thereby, no person
will be employed In violation of the Labor Code of the Beate or Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Imurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (E—pt DEMOLITIONS whtch
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
.hall be comp[ tcd jy%l..tY days; MOVED -IN BUILDINGS shall be cum-
knowledged In space provided.
pleled )
BIG Elt Olt AGENT)
DATE d NE
INSPECTION
Dl TOR'H SiGNATUft
DEPARTMENT
CITY OF
ED51OND$
DATE—�j
N E: Ahpfica,)t Subject to Plan C rck 'ee
_
775-2525_._{
Thi, I'ennIt a ark In be done on primte properly ONLY.
Any Couslruetion on the public dumaln (curbs, sidewalks, driv'ew'ays,
FILE
marquees, etc.) will reeulrr separate perodeslon.
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