640271.pdfF
Permit
NAME OF B'
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ALTER RESIDENTIAL NUMBER OF
DWELLING
QREPAIR NON-RESIDENTIAL UNITS
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I hereby acknowledge that I have read this application; that the In-
formation given In 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 authorized thereby, no person
will be employed In violation of the Labor Code of the state of,Waahlngt=
relating to Workmen's Compensation Insurance.
NOTE: PERMIT LIMIT ONE YEAR
APPROVED
FILE
/ 414
E7 YAFY
E; ZONE
Required
P
0 YES
PERMIT 640271
NUMBER
0 YES E3 NO
ALL BUILDING SETBACKS
NOTE: TO EAVM LINES
NO
[] NO
BY
NO. OF
BUILDING
VALUATION
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
DEMOLITION
5
PERMIT FEE
61
AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
13 YES 13 NO
&V
I
MEN
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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.