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PERMIT APPLICATI N
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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-
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 Your (Except DEMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
plated In six months.)
NOTE: Applicant Subject to Plan Check Fee
Thin permit coven work to be do" on private property U14JUX.
Amy construction on the public domain (curb$, sidewalks, driveways,
marquess, etc.) will require separate permission.
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PERMIT -
NUMBER
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5'3�e - '3_23� #0 e C�o .
C I 10 YES
EXISTING -STREET R/W ........ ... FT -
COMP. PLAN ST. R/W ....... .... FT-
13 YES [3 NO
plan Check NO....
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTEI#MON
THISPERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PH 6-1107
V"J
DEFICIENCY THIS PROPERTY
YES 0 NO
Valuation I Fee
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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 space provided.
FILE
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