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660456.pdf
J t n ....._._Ado,_Ado A A i 1 o - m T 11 n ..5 f;8aYLSt.s� uyi y C !. sill Vet r ! t wswae.e+ni �l)( 1 did, (�fi ^1 ri n.r r do A I' BOILDING DEPARTMENT I Applicant .;;:PERMIT APPLICATION Inside heavy Lines .90 J I 1 i SS �... , ©. OL ` m pl e ✓ice: crl AQ11E CITY 9 TELEPHONE NUMBER to /Up ,►ME �N� L 1). 1�1 o R )Q 15 ODTY ELEPHONE NUMBER AJ NAME 0 t)/t Tip JAke- ADDRESS ffTff TE�PHONE NUMBER LYOU 1,0 0 0 A,.D � FK' 1, — a r s e aS L,FT OF 3' FF_A)CE 11 NEW U BION q ❑ ADD DF.MOI.IBH FENCE ti ALTER I rQ�RESIDENTIAL I NUMBER GOP DWELLIN REPAIR NON-RESIDENTIAL UNITS 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 coastructlon; 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.) 3 NOTE: A(i/llicant Subject to Plan Check Fee This Permit covers work to be done en private property ONLY. Any construction on the public domain (curbs, sidewalks, drlveways, marquees, etc.) will require separate permisslon, n ` e BUILDING I VALUATION BUILDING PERMIT 2 FEE PLUMBING 7 PERMIT FEE HEAT d: OAS LINE 4 PERMIT FEE SIGN PERMIT d FEE dood DEMOLITION d PERMIT FEE ATTENTION THIS PERMIT AUTHORIZES ONLY THE WORK NOTED INSPECTION DEPARTMENT CITY OF EDMONDS Pit 0-1107 �•�� I 1A Af 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 aclalowledged in space provided. ; SIGN Add A. i- �, i j FILE A At