750267.pdfLegal Description Of Property (Show Below Or Attach Four Copies)
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PERMIT APPLICATION
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Legal Description Of Property (Show Below Or Attach Four Copies)
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PLAN CHECKED BY
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Title Penn it r cork to be done on private pro petty ONLY.
OF EDMONDS. LOCAL SALES TAX
Any constructiondrlveSS'a1.'
s, the pwillC equine ecurbs, permission.
nuvaueee, rir.) will rcautre separate nermledon.
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HOUL BE CODED 31.04.
FILE
❑ ADD E]DEMOLISH ❑ 1ALL KING
MAR
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ALTER ❑
OIL FILL (.......... X .......... Ft.)
REPAIR
❑ INSP. O POOL
NUMBER OF STORIES NUMBER OF
Z DWELLING /
UNITS
NATURE OF WORK TO BE DONE
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1•lan check No .....................
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BUILDING
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4 PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Building aetbaeks, abutting street.)
HEAT A GAB LINE
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1 hereby acknowledge that I Save read this application; that the In -
formnllun given le correct; and that I am the owner, or the duly author.
Iced agent of the owner. I agree to comply with city and .late law. relic.
ATTENTION
APPLICATION APPROVAL
,,ting construction; and In doing the work authorised thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington
THIS PERMIT
This application is not a permit until
-
relating to Workmen's Compensation, Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
'
NOTE: Permit Limit One Year (Except DEMOLITION" which
ONLY THE
µ'0R8 NOTED
uty; and fees are paid, and receipt is ac-
.bellbe completed hr nicety day.; MOVED -IN BUILDINGS shall be in.
Imowledged in space provided.
p,eted In six month..)
SIGNATURE (OWN R Oft A NT) DATE 81GNEU
INSPECTION
IR DR' SIONATUR
DEPARTMENT
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/
CITY OF
NOTE: Applicant Check Fee
EDMONDS
ATE
Subject to Plan
775.2525
Title Penn it r cork to be done on private pro petty ONLY.
Any constructiondrlveSS'a1.'
s, the pwillC equine ecurbs, permission.
nuvaueee, rir.) will rcautre separate nermledon.
FILE
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911
❑ YES �.No
PLAN CHECK£ BY THIS SITE IS LOCATED IN THE CITY
!,O^ OF EDMONDS. LOCAL SALES TAX
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NATURE OF WORK TO HE DONE
ABUILDING DEPARTMENT pplicant Fln
DE LE n PERMIT . /
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Fee
Receipt No.
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PERMIT APPLICATION I Inside Iicavy Lines
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ADDRESS
REMARKS
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911
❑ YES �.No
PLAN CHECK£ BY THIS SITE IS LOCATED IN THE CITY
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NATURE OF WORK TO HE DONE
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Fee
Receipt No.
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Pion Check No .....................
REMARKS
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CC ADDRESS
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PROPOSED UBE
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TELEPHONE NUMBER
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aPLOT PLAN (Indicate Building setbacks, abutting streets)
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METER 1?'.I SE12V10E BIZ£ CLEARANCE
CHECKED'BY i
V STATE LICENSE NUMBER CITY LICENSE NUMBER
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Legal Description of Property (Show Below or Attach Four Copies)
REMARKS
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SIGN
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TYPE CONNECTION
VERIFIED
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FIRE ZONE TYPE OF CONSTRUCTION M ROVED
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RESIDENTIAL ❑ LINE
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❑ ❑ SIGN
❑ ADD
❑ RETAINING
DEMOLISH WALL
ALTER ❑ EXCAVATE ❑ FENCE
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❑ YES �.No
PLAN CHECK£ BY THIS SITE IS LOCATED IN THE CITY
!,O^ OF EDMONDS. LOCAL SALES TAX
I,,l�%i�;f%;lgr,.r.-r_! SHOULD BE CODED 31.04.
f}EMAR{C�
/%// (l/N .�/.(//%/%//✓/✓ !LN f/i/iC= `/ / �..'
SWIM
❑ REPAIR ❑ El/
INSPPRE-MOVE POOL
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NUM 6ER OF STORIES NUMBER OF
DWELLING /
UNITS
NATURE OF WORK TO HE DONE
Valuation
Fee
Receipt No.
Pion Check No .....................
BUILDING
PROPOSED UBE
PLUMBING
V
aPLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT k GAB LINE
f� ��•V�.,
9
�
FENCP•.
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION I II
PRE -MOVE INSPECTION I l!
EXCAVATION OR FILL
?
TOTAL AMOUNT DUE
I hereby acknowledge that I have rend 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 slate laws regu- ATTENTION APPLICATION APPROVAL
laling construction; and In doing the work authorized thereby, no person
will be employed in violation of the Labor Cade of the State of Washington THIS PERMIT This application Is not a permit until
relating to Workmen's Compensation Insuranee. AUTHORIZED
ONLY THE signed by the Building Official or his Dep- i
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and feet( are paid, and receipt is Go
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com• knowledged In apace provided.
pleted In six month,.) s'`•.1 (�
31GNATURE (OWNER OR AGENT) I DATE SIGNED INSPECTION DIR OTOR'B SIONATUREI
/ DEPARTMENT
.fir''<.,.,, �i� t_'- - I •�. i i�.�.::.. !iec .:.{.,,J, �1
� ' CITY OF ATE •- n _ __ __
EDMONDS
NOTE: Applicant Subject to Plan Check Fre
775-2525
This Permit a• work to be done on private property ONLY.
Any construction on the public
domain (cache, sidew•niks, dr V ways, INSPECTOR
marquees, etc.) will require separate permission, i"
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