660207.pdfPARTMENT I Applicant F111
LICATION inside Ifeavy Ux
eld .95,
or
NEW I OF SIGN
ADD 'I FENCE
ALTER RESIDENTIAL NU 'a OF
D XLLI N G
REPAIR NON-RESIDENTIAL UNITS
I hereby icknowledge that I have read this application; that the in-
formation given to correct; and that I am the owner, or the duly author -
bled agent of the owner. I agree to comply with city and state laws regu-
Is,ting 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 workman's Compensation Insurance.
(Except Demolitions which shall
NOTA Pxmit MO One Your be completed In nlnety days.)
MY
"NOTE: Applicant Subject to Plan Check Fee
This Permit covera work to be delta au private protterly ONLV.
Any construction 041 the public damalu (curb$. sidewalks, driveways,
ilu%rquee*, Cie.) alit require separate per"llaslo".
El YES M-1fo-',
1112� /-10-
BUILDING
VALUATION
BUILDING PERMIT
2
FIDE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
PERMIT FEE
SIGN PERMIT
5
FEE
DEMOLITION
6
PERMIT FEE
PLAN CHECK
7
FEE
8 1 AMOUNT DUE
A'f4=NTION
THIN PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
pit 6-1101
PERMIT
NUMBER
e,
FA
NO
I
[3 NO
APPLICATION APPROVAL
This application is not a perinit until
signed by the Director of Building Inspee-
tion, or his deputy; and fees are paid, and
receipt is acknowledged In space provided.
FILE
all