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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 lawn regu-
luting 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!a Compensation Insurance.
NOTE: PERMIT LIMA ONE YEAR /I
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APPLICATIPN 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.
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