660106.pdfR q
POSTED ON KROLL MAP NO.: BUILDING
PERMIT
DEPARTMENT Applicant FM NUM33ER 660 106
1 rt
Inside Heavy Lines JOB ADDREBB
:'APPLICATION
ME OF BUSINEI�R)
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I
SIDE YARD BE
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USE ZONE
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or
I
-I- FIRE ZONE TYPE OF
LP-ECIAL INSPECITOR RE
_�] 0 YES [I NO
/9'',/
NEW I
Lj SIGN
H
ADD
MOLI
DE SH
I FENCE
I
0
F ALTER
RESIDENTIAL
'UMB T OF
'DWELPLING
11 REPAIR
NON-RESIDENTIAL
I UNITS
I hereby acknowledd'o 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 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.
,Ixcc,t Demolitions which shall
NOTE: Permit Limit One Year be completed in ninety dayr.)
IIGNYU DATE SIGNED
(OWNER OR AGENT)
- X /2 "?,/ j .1e "I I
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
murquees, etc.) will require separate permission.
BUILDING
VALUATION
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT VIM
HEAT & GAS LINE
4
PERMIT F11E
SIGN PERMIT
FEE
DEMOLITION
6
PERMIT FEE
PLAN CHECK
7
FEE
781
DUE&
AMOUNT e
ATTENTION
TIUS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
Pn 6-1107
0 YEB
VARIANCE NUMBER
[] YES [] NO
54
W�A�;Ov 1 2.41411
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.
FILE
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