700194.pdf(
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DING DEPARTMENT Applicant Fill
MIT APPLICATION Inside Heavy Lines
(OR NAME OF BUSINESS)
TE HPLEONE NUMBER
c_, ti"� S;
or
tic
GAS
RESIDENTIAL LINE
NEW ❑ NON-RESIDENTIAL ❑ SIGN
❑ ADD ❑ RETAINING
DEMOLISH ❑ WALL
ALTER ❑ OROFILL E E AVATFC
REPAIR ❑ PRE -MOVE swim
INSP. POOL
LUMBER OF BTORlES I NUMBER OF
DWELLING
UNITS
u
PERMIT
NUMBER 700194
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SIDE YARD BETBACKI STREET BETBACX REAR YARD SETBACK
1oT
USE ZONE I LOT AREA I VACANT BITE
`1 v � — � ❑ YES '�NO
HEIGHT BUILDING AREA VARIANCE NUMBER
I V-4-no
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP, PLAN ST, R/W ............FT. ............FT.
REMARKS
\i.. — n _�_ lrlt \C. cf C C+C
YES NO
Plan Check No ......................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
N
1 SWIMMI4 POOL
DEMOLITION
PRE-MOVF, INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledse 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 elate laws regu- ATTENTION
lating construction; and In doing the work authorized thereby, no Berson
will be employed to violation of the Labor Code of the State of Washington THIS PERDIZT
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
shall be completed In ninety days; BIOVED-IN BUILDINGS shall be com-
pleted In six months.)
i16NATURE (OWNER OR AGENT) IATE BIOrIEU INSPECTION
DEPARTMENT
;'I L,Uj . �% n ����. �G� �t'C} U7"1 ��'ttt-C l -�[ CITY O'r'
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR a-IIo1
This Permit covers
work to
be done
an private Vroperty ONLY.
Any construction on
the public
domain
(curbs, sidewalks, driveways,
marquees,
etc.) will
require
separate permission.
Valuation
YES NO
C Cs
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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