660213.pdf.1 4
POSTED OF
BUILDING DEPARTMENT Applicant FIU
PERMIT APPLICATION Inside Heavy Lines -TOB —AD,)RE
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PERMIT 660213
NUMBER
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0 YES NO c;
31=
HEIGHT BUILDING A.REA VARIANCE NUMJ -11
I PLOT PLAN APPROVED
I hereby acknowledge 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.
(Except Demolitions which shall
NOTE: Permit Limit One Year be completed In ninety days.)
N0fEN--2'rrpficant Subjcct to Plan Check Fcc
This permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, drivewaym,
m,rqueest etc,) will require neparstr permission,
13 YES E3 NO
BUILDING
VALUATION
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
SIGN PERMIT
5
FEE
DEMOLITION
6
PERMIT FEE
7
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FEE ZX%f,
8
AMOUNT DUE 6
ATTENTION
THIS PER511T
AUTHOIUZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
[3 YES [3 NO
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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.
DIRECTO 8 SIGNA�YV
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