670424.pdfBUILDING DEPARTMENT I Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
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MAP NO.: PERMIT �AI
NUMBER 070424 ,
RM
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FAY
11 B/µ,
KISTING STREET R/W
COMP. PLAN ST. R/W FT,
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I)B Y ! / G 16/ 1 PERO. TEST
RESIDENTIAL MGAS
LINE
NON-RESIDENTIAL ❑ SIGN
❑RETAINING
DEMOLISH WALL
EXCAVATE FENCE
OR FILL (....... s....._...Ft.)
aPRE MOVE SWIM
INSP. POOL
'.IEB NUMBER OF
DWELLING.
UNITS
I hereby acknowledge that I have read this appllratlon; that the in-
formation given is correct; and that 1 am the owner, or the duly author.
lz d 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.
NOTE: Permit Limit one Year (Except DEMOLITIONS which
shall be completed to ninety days: MOVED -IN BUHMINGS shall be com-
pleted in elm months.)
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NOTE: Applicant Subject to Plan Check Fee
This Permit coven
work to
be done
on private property ONLY.
Any construction on
the public
domain
(curbs, sidewalks, driveways,
marqueesr
ego.) will
require
separate permission.
Plan Check No...._.._._........
BUILDING
PLUMBING
HEAT d: GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING
POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
TIUS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDHONDS
Pn 6-im
i137544 al—�%19
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❑ NO
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided,
._-
FILE
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