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I hereby acknowledge that I have read this application; that the In.
formation given to correct; and that I am the owner. or the duly author-
ized agent of ths owner- I agree to comply with city and state laws regu-
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
relating to Workmen's Compensation Insurance.
NOTE: PERMIT LIMIT ONE YEAR
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BUILDING PERMIT
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PERMIT FIX
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AMOUNT DUE
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INSPECTION
DEPARTMENT
CITY OF
EDDIONDS
PR 6-1107
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APPLICATION APPROVAL
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This application is not a pern-tit. until
signed by the Director of Building Inspec-
tion, or his deputy; and fees are paid, and
receipt is aelmowledged in space provided.
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PLAN FILE NUMBER
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I hereby acknowledge that I have read this application; that the In- ATTENTION APPLICATION APPROVAL
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- THIS PERMIT This application is not a permit until
lating construction; and in doing the work authorized thereby, no person AUTHORIZES signed by the Director of Building Inspec-
will be employed in violation of the Labor Code of the State of Washington ONLY THE tion, or his deputy; and fees are paid, and
relating to Workmin's Compensation Insurance. WORK NOTED receipt is acknowledged in space provided.
NOTE: PERMIT LIMIT ONE YEAR
INSPECTION DIRECTOR'S SIGNATURE
SIGRATUYFE (OWN —MR Oft AGENT) _1DATF Sl - GNED DEPARTMENT
CITY OF
t i�L" DATE
EDMONDS
LAN CHECK & APPROVED
LOT P
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PR 6.1107
INSPECTOR