660236.pdf:U,ILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION I Inside Heavy Lines
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DEMOLISH
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I hereby acknowledge that I have read this 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 regui-
the In'
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uth�
re
lating construction; and In doing the work authorized thereby, no person
will be employed In Vlolation Of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
x Demolitions which shall
NOTE: Permit Umit One Your 'be' c'o`mpleted In ninety days.)
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SIGN3 OWNER OR A DATE SIGNED
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!VOTE: Appli"nt Subject to Plan Cbeck Fee
This Permit ooven work to be done on PrIMIle property ONLY.
Any construction an the public domain (curbs, sidewalks, driveways,
marquess, etc.) will require separate permission.
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,S-S-6-410
ZONE
[] YES 13 NO
BUILDING
I
VALUATION
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
SIGN PERMIT
5
FEE
DEMOLITION
6
PERMIT rEE
PLAN CHECK
7
FEE
8 1 AMOUNT DUE
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660236
13 YES (3 N 0
VARIANCE NUM=B I
[3 YES [3 NO
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ArrENTI[ON I APPLICATION APPROVAL
THIS PERMIT This application Is not a permit until
AUTHORIZES
ONLY THE signed by the Director of Building Inspec-
WORK NOTED I tion, or his deputy; and fees are paid, and
receipt Is aelmowledged In space provided.
INSPECTION R's 1110
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
FILE
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