640267.pdfM
uilding Permit Application II, 'PPI'ean' "'
side Heavy Lines
NAME (OR NAME OF BUSINESS) Seaview Height�
Edmonds School District #15 Elementary
"LING ADDRESS
3 , 800 - 196th S. W.
CITY I TELEPHONE NUMBEIR
Alderwood Manori, Wash. I PR8_8931
�'"Aoq
CITY TELEPHONE NUMBER
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BLOCK AND PIER foundation
for portable classroom
F� NEW DEMOLISH NUM13ER OF STORITE
ADD 1
ALTER RESIDENTIAL NUMBER OF
DWELLING
E] REPAIR El NON-RESIDENTIAL I UNITS
PROPOSED USE
to place portable building on
I hereby acknowledge that I have read thin application; that the in-
formation given Is correct; and that I am the owner, or the duly author-
lzed agent of the owner. I agree to comply with city and state lawn 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
& APPROVED
FILE
I I V__
YES
C] YES
C
PERMIT
NUMBER
I
YES N
Z
V ARIANCE NUMBER 01
NOTE: TO"EAVE LINES
[] YES [3 NO
In
NO. OF H�Dua. PERJULUG. TOTA� FK& Z
BUILDING
VALUATION 0
BUILDING PERMIT
2 FEE
PLUMBING
3 PERMIT FEE
HEAT & GAS LINE
4 PERMIT FEE
DEMOLITION
5 PERMIT FEE
6 AMOUNT DUE
ATTENTION APPLICATION APPROVAL
THIS PERMIT This application Is not a perinit until
AUTHORIZES
ONLY THE signed by the Director of Building Inspec-
WORK NOTED tion, or his deputy; and fee.- are paid, and
receipt is aelmowledged in space provided.
INSPECTION DIREC SIGNATURE
DEPARTMENT
CITY OF
EDMONDS DATE
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