660431.pdfi
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PERMIT
BUILDING DEPARTMENT Applicant Fill yl NUMBER
PERMIT APPLICATION Inside Heavy LI ies =OB ADDRESS
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Legal Description 09 Property (Show Below or
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NEW 1 1:1 " SIGN
ADD DEMOLISH 11-1 FENCE
ALTER RESIDENTIAL NUMBER OF
DWELLING
REPAIR NON-RESIDENTIAL I UNITS
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1 bereby 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 lawn regU-
tating 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 tiffiftfte Year (Except Demolitions which shell
be completed In ninety days.)
-AOTE: APPli""t Sitbject to Plan Chcrk Fec
This ii-ernut coven work to be done on prIvntc Property ONLY.
Any construction on the public domain (curbs, 5111OW0101, driveways,
nunrquees, etc.) will require separate pern-Aselon.
660431
YES 13 NO
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PERO. TEST
FIRE ZONE zFE OF
SPECIAL INSPECTOR RE
0 YES [3 NO
BUILDING
VALUATION
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
—
_WEAT & GAS LINE
4
PERMIT FEE
SIGN PERMIT
5
FEM
DEMOLITION
6
PERMIT FEE
PLAN CHECK
7
FEE
8 1 AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6.1107
0 YES [3 NO
. FOR
APPLICATION APPROVAL I I �j
This application is not a perntit until
signed by the Director of Building Inspec-
tion, or his deputy; and fees are paid, and
receipt Is aclmowledged In space provided.
D Is Of
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