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660401.pdfING DEPARTMENT I Applicant I= 1IT APPLICATION Inside Heavy Lines 6 ev Clej IV, JI[AILING ADDRESS N ?-4 TE;LEJLjkiUNE 14UMBER .,�A,-j r� iv s 7� ("o STATE LICENSE NUMBER CIT'r Lac Z-1 ­0 / 4).3.a / I Legal Description of Property (Show Below or Attach 0 / — NEW SIGN NUMBER OF STORIES E] ADD I DEMOLISH FENCE 0 ALTER RESIDENTIAL NUMBER OF REPAIR NON -RESIDE] DWELLING UNITS 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- lzed 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 WasItIngton relating to Workin's Compensation Insurance. (Except Demolitions which shall N&L- Per4� Limit One Your be completed In ninety days.) V NOTE: Applicant Subiject to Plan Check Fee This Permit covers work to be done on Private Property ONLY - Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate Permifialon. I ,to -74— ZONE NO.: B qG PE 660401 NUMBER I 13 YES C3 No VA—RIANCM NUMEFr—,R-- SIZE I BERVICEAIZE I CLEARANCE I C17 y REPAnKS 0 YES n-r fG, I I VALUATION BUILDING PERMIT 2 FEE PLUMBING 3 PERMIT FEE HEAT & GAS LINE 4 PERMIT FEE SIGN PERMIT 5 FEE DEMOLITION 6 PERMIT I= PLAN CHECK 7 FEE 81 AMOUNT DUE ATTENTION THIS PERMIT AUTHORIZES ONLY THE WORK NOTED INSPECTION DEPARTMENT CITY OF EDMONDS PR 6-1107 YES E3 NO APPLICATION APPROVAL This application is not a pern-dt until signed by the Director of Building Inspec- tion, or his deputy; and fees are paid, and receipt Is aclmowledged in space provided. — C;L � - FILE Z 0 1. ILL I '.I I I . . .... ILI I i tp I L I if I L �,l t If 1; , i7, OOL f I ILL t 6 1 4 L Ll L I ILL, I 'j,4 111 If r�,l I I ILL Of? 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