660492.pdf0
PQSIED ON KROLL MAP NO.: 13UILDING
PERMIT
BUILDING DEPARTMENT Applicant Fill NUMBER
1 66045
Inside Heavy Lines
JOB ADDRESS
PERMIT APPLICATION
R-NAME OF BUSINESS)
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EIGHT BUILDING AREA I
17
Description of Property (Show Below or Attach Four Copies)
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NUMBER OF
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NON-RESIDENTIAL
DWELLING
UNITS
I hereby acknowledge that I have read this application; that the In-
formation given to 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.
IEII,pl Demolitions which shall
NOTE: Permit Limit One Year be completed In ninety days.)
SIGNATURE (OWNER Oft AGENT) DATE SIGNED
NOTE: Applicant Sitbject 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 permission.
[I YES
4
1 1 VALUATION
10) W
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
BEAT & GAS LINE
4
PERMIT FEE
SIGN PERMIT
5
PEP,
DEMOLITION
PERMIT FEE
PLAN CHECK
FEE
81 AMOUNT DUE
ATTENTION
THIS PERMIT
AUTIZOIUZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
Pit 6-1107
I [:] YES 13 NO
ALNCY GROUP
APPLICATION APPROVAL
This application IS not a permit until
signed by the Director of Bulld!ng Inspec-
tion, or his deputy; and fees are paid, and
receipt is aelmowledged in space provided.
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