660595.pdfI
DUILUIRU DEPAKI E n
PERMIT APPLICATION
1 NAM .(OR NAM OF BUSINESS)
I Z. 6 M �',5 �-. �A
MAITUNG ADDRESS
�7 / /j A o
POSTED ON KROLL MAP NO.: PERMIT
NUMBER
Appll,tl Fill
Inside H I y Lines 1=033
or AEMCn k'
EINEW
Z RESIDENTLA
R
E]
NON-RrSIDE TIAL
F1DEMOLISH
El
ALTER
F
EXCAVATE
OR FILL
REPAIR
PRE -MOVE
INSP.
DIMELLING
UNITS
A14,
t
N
I
I hereby acknowledge that I have read this applicau ; that the In-
formation given to correct; and Mat I am the owner, or tl a duly author.
lzed agent of the owner. I agree to comply with city and a ato 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 Imurance.
NOTE: Permit Limit One Year (Except DE310rITIONS which
shall be completed in ninety days; MOVED -IN BUILDING� shall be com-
pleted In six months.)
NOTE: Applicw'it Subject to Plan (
This rermit covers work to be done an private
Any construction on the public domain (curbs. sJd4
marquees, etc.) will require separate pe
Fee
y ONLY.
driveways,
E313STING STREET n/W ............ FT
COMP. PLA14 ST. R/W ............ IT
0 YES 0 NO
Plan Check No ............
BUILDING
PLUMBING
HEAT & GAS IMM
FENCE
bt)UJ
I
rZ
VACANT SITE
[3 YES [3 NO
I
p4
I
VARIANCE NUMBER
DEFICIENCY THIS PROPERTY
....... ....
Z
CHECKED BY
wl
[3 YES [3 NO
Fee
RETAINING WALL
,
,:tt—
L.�-D t4 I
SWIMMTNG POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATMNTION
APPLICATION APPROVAL
THIS PERMIT
This application is not a permit until
AUTHOnIZES
signed by the Building Official or his Dep-
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION
DEPARTMENT
DI RE9TO
�'J'S BIG 'RE OFF
CITY OF
EDmoNDS
DATE
PH 6.1101
FILE
*A _ - - .- �