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NEW
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NON-RESIDENTIAL
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ADD
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RETAINING
1:1
DEMOLISH
WALL
EXCAVATE
PENCE
ALTER
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OR FILL
(..—...-x St.)
REPAIR
F-1
PRE -MOVE
INSP.
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swim
POOL
DWELLING
o NJ Er UNITS 0 iti tF_
MAP NO.;
PZnMIT
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I NUMBER
04Ld";e
STREET HETHACIL
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EXISTING STREET R/W-!��
COUP. PLAN ST. R/W.—
REMARKS
DEFICIENCY THIS PROPERTY
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4
0 YES (3 NO
Valuation
Plan Check No....___
BUILDING
FLUM33MG
HEAT & GAS LIKE
t
PENCE
SIGN
RLTAJNMG WALL
SWIMMING POOL
DEMOLITION
PRE,MOVE INSPECT70N
EXCAVATION OR FELL
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-
iz6d agent of the owner. I agree to comply with city and state laws regu-
I&Uug roustruction; and In doing the work authorized thereby. no person
will be employed In violation of the Labor Code of the Slats of Washington
relating to WorkmeWs ComPKL'aUOtL Insursmoo.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed in ninety days; MOVED -IN NUEMINGS shall be com-
pleted In sit months.)
— I f- —
NOTB: APPlicant lubirect to Plan Check Pee
Two Permit covers work to be do" an private property ONLY.
Any coustruCtIOR On the Public domain (curbso oldevralksp drivewayme
marquees. ") will require Separate 11cluAssim.
TOTAL AMOUNT DUE
ATTENTION APPLICATION APPROVAL
TIGS PERMIT This application is not a pernilt until
AUTHORZIZES
ONLY THE signed by the Building Official or bill Dep-
WORK NOTED uty; and fees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
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