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PLAN FILE NUMB
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ITY I TELEPHONE NUMBEI
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ALTER RESIDENTIAL NUMBER OF
0 , DWELLING /
REPAIR NON-RESIDENTIAL UNITS
I hereby acknowledge that I have reed thin 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-
laUng 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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CHECK & APpRgVED
/% FILE
BUILDING "
I VALUATION.
BUILDING PERMIT
3 FEE
PLUMBING
3 PERMIT FEE
BEAT h GAS LINE
PERMIT FEE
DEMOLITION
51 PERMIT FEE
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ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
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VE IMED BY
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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. is I
DIRECTOR08 B GNAT
DATE
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" Earl Dillman Morris
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t4r Professional Associate The Seattle Chapter" A.I.A. j
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17306 Seventy Third Avenue West
k#l�1 Edmonds, Washington 9 8 0 2 0
PR 8-1808
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