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T. APPLICATION
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WORK TO BE DON%�' Z 1
PLUMBIN LY
3 PERMIT FEE
HEAT & GAS LINE
4 PERMIT FEE
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N NEW SIGN SIGN ?ERMIT
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P9 ALTER RESIDENTIAL LING PLAN CHECK
REPAIR NON-RESIDENTIAL UNITS 7 FEE
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PROPOSLW U021 8 AMOUNT DUE IQI(�Lc"
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I hereby acknowledge that I have read tbIX application; that the in- ArMNTION APPLICATION APPROVAL
formation given I$ cOrr6ct; and that I am the Owner- or the duly author- This application is not a permit Until
Ized agent of the ovmer. I agree to Comply with city and state laws rcgu- THIS PERMIT
lating construction; and In doing the work authorized thereby, no person AUTHORIZES signed by the Director of Building Inspec-
will be employed In violation of the Labor Code of the State Of Washington ONLY THE tion, or his deputy; and fees are paid, and
relating to WorkmeWs Compensation Insurance- WORK NOTED receipt is acknowledged in space provided.
rxcept Demolitions which shall
NolmPermit Lqlt One Your b"c completed In ninety days.)
I I INSPECTION DIRECTOR'S 0
71-0 fi il 1, Iff 011 AGENT) GNED AnTMENT
DEP
za��o CITY OF DATE V
no�- EDMONDS
'WnTF4 PR 6-1107
NOTE: Applicant Subject to Plan Check Fee
This permit coven wwK w . done on private property ONLY. FILE
Any construction On the public domain (curbs, sidewalks, driveway",
ninequees, etc.) will require fleparste perrnifislon.
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