650009.pdfPermit
ALTER
REPAIR
...._._._.)._.
NUM
0
RESIDENTIAL NUMBER OF
DWELLING
NON-RESIDENTIAL UNITS
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-
Iced 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 Washington
relating to Workmen's Compensation Insurance.
NOTE: PERMIT LIMIT ONE YEAR
SITU R AGENT) DATE SIONED
ILI
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ILL
S
❑ NO
BUILDING
I VALUATION
BUILDING PERMIT
Y FEE
PLUMBING '
3 PERMIT FEE
HEAT A GAB LINE
PERMIT FEE
DEMOLITION
6 1 PERMIT FEE
61 AMOUNT DUE
ATTENTION
TINS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
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APPLICATION APPROVAL
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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 aclmowledged in space provided.
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