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Lj DEMOLISH
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ALTER
RESIDENTLILL NUMBER OF
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NON-RESIDENTIALI UNITS
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-
lating construction; and in doing the work eLuthorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: PERI�R LIMIT ONE YEAR
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B BUILDING
VALUATION
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BUILDING PERMIT
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3 PERMIT FEE
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4 PERMIT I=
DEMOLITION
5 PERMIT FEE
AMOUNT DUE
ArMNTION
THIS PERMT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1101
PERMIT
NUMBER
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OF
APPLICATION APPROVAL
This application is not a permit until
signed by the Director of Building Inspec-
tion, or his deputy; and fees are paid, and
receipt is acknowledged in space provided.