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0 0.1PARTMENT I AppHosint M
� APPLICATION neide Iffeavy unes
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I RE -MOVE
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REPAIR E]
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UNITS
NATURE OF WOiM —TO BE DONE
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PLOT PLAN (Indicate Building setbacks, abutting streets)
I hereby acknowledge that I have read this &PPUCLUOU; Met the In-
formation given is 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
relaung to Workmans Compensation Insurance.
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS she.11 be a= -
plated in six months.)
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V NOTE: Applicj?t Subject to Plan Cbech Fee
This Permit covers work to be done = private properly ONLY.
Any constraction on the p0bllc domain (cudw, sidewaW, driveways,
mamees, ate.) will require separme permission.
[3 YES 13 NO
PERMIT
NUMBER
13 YES C3 NO
DZFICIENCY THIS PROPERTY
r] YES 13 NO
Minima fee charged for public building ia
lieu of regular fee, I
Plan Check
BUILDING
PLUMBING
ELMAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEKOLMON
PRE -MOVE INSPECTION
EXCAVATION OR FILL
ITOTAL AMOUNT DUE
ATTENTION
TIM PERSM
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
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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 apace provided.
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