680140.pdfPO, Box 334
61TY
Edmonds. Wne
or
See attaLchede
Q RESIDENTIAL
M
LINE
F1NEW
1
11 NON-RESIDENTIAL
SIGN
DADD
El
RETAINING
WALL
DEMOLISH
ALTER
EXCAVATE
r_1
FENCE
IN
OR FILL
( .......... x ..........
PRE -MOVE
REPAIR INSP.
0
swim
POOL
NUMBER OF STORIE13
NUMBER OF
DWELLING
UNITS
WO]
Additiowa P1b90 and floor
spacee
See permit #680028
ZONE
0 YES [] NO
Plan Check No ............
BUILDING
PLUM[BINO
HEAT & GAS LINE
PENCE
t
N
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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- ATTENTION
latlng construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington THIS PERMIT
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONR which WORK NOTED
shall be completed In ninety days: MOVED -IN BUILDINGS shall be com-
pleted In six month INSPECTION
14 — DATE SIGNED
I GENT)
3IG (OWNER DEPARTMENT
4-8-68_ CITY OF
AIONDS
NOTE: Applicant Subject to Plan Check Fee PR 0-1107
This Permit covers work to be done on Private Property ury"-
Any construction on the public domain (curbs, sidewalks, drivewaYs,
marquees, etc.) %vill require separate permission.
CHECKED BY
JULNCE
CHECKED BY
VERIFIED BY
PERMIT NUMBER
3ox STREET IMPROVED
YES NO
OCCUPANCY GROUP
Valuation
iz-0 I rl. r e
Receipt No.
r7-
APPLICATION APPROVAL
This application is not a perntit until
signed by the Building official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in Space provided.
DATE
FILE
I