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PLAN CHECK
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TELEPHONE NUMBER
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STREET AND/OR UTILITY ❑YES
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ORIGINAL - File YELLOW -inspector
marquees, atc.) will require separate permission.
UNDERGROUND ❑ YES
PINK - Owner GOLD - Auesvx
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BE CODE
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PLAN CHECK
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6 PLOT PLAN INDICATE BUILDING SETBACKS,
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NOTE: Permit Limit One Year (Except DEMOLITIONS which
SIGN
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DIRECTO IG T RE
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REPAIR
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BE CODE
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UMBER OF STORIES
NUMBER OF
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6 PLOT PLAN INDICATE BUILDING SETBACKS,
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PLUMBING
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AUTHORIZES
FENCE
NOTE: Permit Limit One Year (Except DEMOLITIONS which
SIGN
uty; End fees are paid, and receipt is aC-
R TAINING WALL
WORK NOTED
SWIMMING POOL
VALUATION FEE
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I hereby acknowledge that I have read this application; that the In-
TOTAL AMOUNT DUE
tormntton elven In correct: and that I ard the owner, or the duly wNru-
ized agent or the owner. [ agree to comply with city and state laws tegu-
lating construction; and In doing the work authorised thereby, Bo person
ATTENTION
APPLICATION APPROVAL
wlll be employed In Violation of the Labor Code of the Stale of Waablailton
T 1 PERMIT
relat jug to Workmen's Compensation Insurance.
This application is not a permit until
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
uty; End fees are paid, and receipt is aC-
shell be completed In ninety days; MOVED -IN BDILDINOS shell be cord-
WORK NOTED
knowledged to space provided.
pleted m six monuua
INSPECTION
IGNA URE (OWN[R OR AGENT) DgTE IGNE
X97)
DEPARTMENT
DIRECTO IG T RE
,� ✓'-/ /.
- CITY OF
EDMONDS
DATE/
NOTE: Applicant Subject to /'tan Check Fee
775-2525
.
This Permit covers work to be dona on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
ORIGINAL - File YELLOW -inspector
marquees, atc.) will require separate permission.
PINK - Owner GOLD - Auesvx
NOTIi: Applicant Subject to Plan Check Fee I {
775-2525 ,1 ! , I•.�-
This Permit covers work to be done an private property ONLY, ORIGINAL - file YELLOW - Inspector
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission. PINK - O—er COLD - Assessor
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USE PERMIT .1 I
BUILDING DEPARTMENT Applicant Fill ZONE NUMBER
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PERMIT APP Inside Heavy Lines ADD
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THIS SITE IS LOCATED IN THE CITY
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NAURE OFWORK TO BE DONE .
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Legal Description of Property (Show Below or Attach Four Copies) STREET AND/OR UTILITY ❑YES
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WORK REQ`D ❑ NO
UNDERGROUND ❑ YES
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y PLOT PLAN INDICATE BUIL ING_SETSACKS,
ABUTTING ST E Tel -
NOTIi: Applicant Subject to Plan Check Fee I {
775-2525 ,1 ! , I•.�-
This Permit covers work to be done an private property ONLY, ORIGINAL - file YELLOW - Inspector
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission. PINK - O—er COLD - Assessor
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❑ NEW RESIDENTIAL GAB
LINE
—Is,
FIRE ZONE E TYPE OF CONSTRUCTION CODE
,
❑ NON-RESIDENTIAL SIGN;,.//_�'L
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RETAINING
❑ ADO ❑ DEMOLISH ❑
SPECIAL INREQUIRED SPECTOR AREA
OCCUPANCY OCCUPANT
GROUP : LOAD
WALL
NO
F
❑ ALTER [:]EXCAVATE ORFI❑ i ENCE X_FT)
ED BY
O ANYES CH EC K❑
THIS SITE IS LOCATED IN THE CITY
w i
OF LOCAL SALES TAX
F-1 REPAIR ❑ PRE -MOVE ❑ POOL
INSP.
HOU D eE
Z
NUMBER OF STORIES NUMBER OF
REMARKS
+ :,
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1_ %i�
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DWELLING
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UNITS
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NAURE OFWORK TO BE DONE .
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VALUATION FEE
PROPOSED USE
PLAN CHECK
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ABUTTING ST E Tel -
BUILDING
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PLUMBING
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D
W
HEAT 8: GAS LINE
O
FENCE
SIGN
RET'AI NING WALL
SWIMMING POOL
I hereby acknowledge that I have read this appilcatlpn; that the In•
TOTAL AMOUNT DUE
tormatlon given Is correct; and that I am the owner, or the duly author -
fired agent of the owner. I agree to comply with city and stats lawn mau•
ATTENTION
APPROVAL
Isting conetructlon; and In dolOg the work authorized thereby, no person
APPLICATION
Will be employed In v101ntlon at Ne labor Cada o[ Ibs elate o! Washington
THIS PERMIT
This application 19 not B elTrlit until
pp p
[elatlog to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (EscePt DEMOLITIONS whleh
ONLY THE
Uty; and fees are paid, and receipt is ac-
ellnll be completed In Nnety days; MOVED -IN HUILD1N08 shalt be 0010-
WORK NOTED
WORK
in apace provided.
pleted In els months.)
INSPECTION
SIGNATURE TOWNER OR AGENT) DATE JSIG NEO
0 DEPARTMENT
DIRECTOR'S SIGNATURE
7 I�
CITY OF
'?'� r•(�....
EDMONDS
DATE
NOTIi: Applicant Subject to Plan Check Fee I {
775-2525 ,1 ! , I•.�-
This Permit covers work to be done an private property ONLY, ORIGINAL - file YELLOW - Inspector
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission. PINK - O—er COLD - Assessor
1
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