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.;' BUILDING DEPARTMENT Applicant FM
M PERMIT APPLICATION Inside Heavy Lines
(OR NAME OF BUR I SR)
.:: A ctJ
ONE NUMBER
'....:.':.,,.`. TELEPHONE NUMBER
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N11 T.4/I L 0 Y
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TELEPH�13t
RATELICENSE NUMBER CITY LIE
(.� Legal DescriDt on or Property (Show Below
,,or Attach
NEW I M I u SIGN
Li
ADD DEMOLISH I
FENCE
NUMBERALTER RESIDENTIAL
REPADi I NON RESIDENTIAL I UELLI OF
DWELLING
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.
NOTE: Permit Limit One Year be cceompllxmdoi Demolitions whichttdays.)
eshall
116NAT (OWNER OR T) DATE IGNE
GG
NOTE: Applican Subicct to Platt Check Fee
This Permit coven
work to
be done
on private property ONLY.
Any construction on
the public
domain
(curbs, sidewalks, driveways,
marquees,
etc.) will
require
separate permission.
S✓
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�;yeS`T
❑ YES
11 VALUATION
BUILDING PERMIT
2 FEE
PLUMBING
S PERMIT FEE
HEAT & GAS LINE
6 PERMIT FEE
SIGN PERMIT
5 FEE
DEMOLITION
8 PERMIT FEE
PLAN CHECK
7 FEE
8 AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 0-1107
�c
It
PERMIT
660393
NUMBER
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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,
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August 24, 1966
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Re: Building Permit660393 ..i, M1�
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New Residence at 15908 - 75th Pl. W.` (( a' Y`t,'
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Y I
{ Lrr pi
In lieu of soil test data, I am aware of the possible unstable soil F .
condition of this area at this time. ' +IL'�"+ILL
yor
Therefore, I will not hold the City of Edmonds responsible for any {, `
damage under the above conditions. h,t;�';i;
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