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STREET AND/OR UTILITY ❑ YES
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❑DEMOLISH RETAINING
SPECIAL IR INSPECTOR ARE
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OCCUPANCY OCCUPANT
GROUP LOAD
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NUMBER OF STORIES
NUMBER OF
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NATURE OF WORK TO BE DONE
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VALUATION FEE
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SIGN
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TOTAL AMOUNT DUE
I hereby acknowledge that I have read this epPllcatlon; that the In-
tormatlon glven Ie correct; and that I am the owner, or the duly author-
feed agent of the owner. I agree to comply with city and Stats laws regu-
thereby. no person
ATTENTION
APPLICATION APPROVAL
luting con. Melton; and In doing the work authorlted
will be employed In violation of the Labor Code of the stats of Washington
THIS PERMIT
application is not a permit until
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relating to Workmen's Compensation Itun once.This
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (E—Pt DEMOLITIONS which
ONLY THE
uty; and fees are paid, and receipt is Be-
shall be completed in Nnely days; MOVED-IN BUILDINGS Shall be coon-
WORK NOTED
knowledged in space provided.
plelee In .lx montn..>
INSPECTION
SLGyp TURE W ER OR AGEN; j GATE SIGN D
DEPARTMENT
DIRECT 51 N E
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CITY OF
EDMONDS
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NOTE: Applicant Sub%cc to Plan (%lack- Fee
775.2525
This Permit covers work to be done on private property ONLY.
the domain (curbs, sidewalks, driveways,
ORIGINAL . File YELLOW - hupeclor
Any construction on public
marquees, etc.) will require separate permission.
PINK - Olener GOLD - Axes.er
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PLAN CHECK
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BUILDING DEPARTMENT Applicant Fill ZONE (H f NUMBER
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EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY
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ADD;,RESS COMP. PLAN ST. R/W FT. FT.
will be employed In vlomtloo of the Labor Code of the State or Washington
THIS PERMIT
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CIT TELEPHN NUMBER REM / `S
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Descriptlon of Property (Shaw Belaw or Attach Four Copies) STREET AND' �l�Tl[i1T % YES
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WORK REO'D
UNDERGROUND ❑ E6 _ r�
Dieted In six months.)
INSPECTION
WIRING RE Q'D ❑ N !
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DEPARTMENT
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SEPTIC SYSTEM
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ED MON DS
DATE
NOTE: Applicdnt Sub%ecYfo Plan C73eck Fee
775-2525
METER SIZESERVICE SIZE 1CLEARANCE CHECKED BY
C
W I
This Permit covers work to be done on private property ONLY.
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ORIGINAL •File YELLOW - Inspector
REMARKS J
a •'
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
PINK - Owner GOLD - AS`.e550r
❑ NEW El RESIDENTIAL 1 GAS — • -
CJ LINE FIRE ZONE TWE OF CQNSTRUCIION CODE / ,-
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NON•RESIDEN TIAL SIGN -.}.!-• r`�y \., I �,
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ADO SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
❑
❑DEMOLISH RETAINING GROUP LOAD
REQUIRED .?
WALL ^-_
❑ YES ❑`NO
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❑EXCAVATE FENCE
ALTER ❑ OR FILL ❑ 1_ X_FT)PLAN CHECKED.BY THIS SITE IS LOCATED IN THE CITY
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PRE -MOVE SWIM SHOULD BE
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REMARKS
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NUMBER OF STORIES NUMBER OF
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DWELLING
UNITS
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NATURE OF WORK TO BE OO HE
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PLAN CHECK
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7-15
NO.
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PLOT PLAN INDICATE BUILDING SETBACKS,
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ABU'\T�N,5Si F1E`•Sj`I
BUILDING
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PLUMBING
HEAT & GAS LINE
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FENCE
SIGN
RETAINING WALL
SWIMMING POOL
I
TOTAL
I hereby acknowletlge mat i have read tele applleatlon; that the In-
[ormntlon given iscorrect; and that I am the owner, or the duly author-
ized agent or the owner. 1 agree to Comply with city and elate laws regu-
latingconatMetlon; and In doing the work suthorixed thereby, no person
will be employed In vlomtloo of the Labor Code of the State or Washington
THIS PERMIT
This application Is not a permit until
relalla6 to Workmen's Compeneallon Inaurance,
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY THE
uty', and fees are paid, and receipt is ac
shall be [ompleled In ninety deye; MOVED-INHCILDINOB shell be wm•
WORK NOTED
knowledged in space provided.
Dieted In six months.)
INSPECTION
IGNATURE (OWNER OR AGENT)
DATE SIGNED
DEPARTMENT
OI RECTOR'S'SIGNAT U RE
CY i 7
CITY OF
ED MON DS
DATE
NOTE: Applicdnt Sub%ecYfo Plan C73eck Fee
775-2525
t;?% 1 -7
This Permit covers work to be done on private property ONLY.
ORIGINAL •File YELLOW - Inspector
'
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
PINK - Owner GOLD - AS`.e550r