700424.pdfBUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION InsIde'Reavy Lines
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NUMBER OF
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M0_LL MAP NO.: ERMIT
9r (d NUMBER 700424
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EXISTING STREET R/W ............ FT-
COMP� PLAN ST. R/W ............ IT-
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DEFICIENCY THIS PROPERTY
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REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
13 YES 13 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
[3 YES NO
PLAN CHECKED BY
REM a
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Plan Check No ......................
Fee
Receipt No.
1-1
ING
BUILDING
PROPOSED USE
ING
PLUMBING
NIUM
PLOT PLAN (Indicc—ate Building setbacks, abutting streets)
GAS
HEAT & GAS
0
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
0
I hereby acknowledge 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 state laws regu-AWENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington TIUS PERMT
This application is not a permit until
relating to Workman's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Your (Except DEMOLITIONS which ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
knowledged in space providedL
pleted In mix months.)
INSPECTION
SIGNATURE
(OWNER OR AGENT) DATE SIGNED
DEPARTMENT
CITY OF
EDMONDS
DATE
J,
A46TE: Appli"nt Subject to Plan Check Fee
PH 6.1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
FILE
marquees, etc.) will require separate permission.
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