680534.pdfPOSTED ON KROLL MAP NO.: PERMIT
BUILDING DEPARTMENT NUMBER 680534
Applicant Fill
wide Heavy Lines
PERMIT APPLICATION 1 7]_ joB ADDRESS
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agal Description of Pro erty (Show Below or AIMCU Nuurroplea)
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I hereby acknowledge that I have read this application; that the In-
formation given to correct; and that I ELM the owner, or the duly author-
lzed 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
aball be completed In ninety days; BIOVED-IN BUILDINGS shall be e0m.
pleted In mix MOUthST___) e)
NOTE: APPlicant Subject to Plan Check Fee
7jj_j_& —perndt coven work to be done on private PrOPOrty UNLx-
Amy construction on the public domain (curbs, sidewalks, driveways,
marquees, ete.) wW require separate Permission-
EXISTING STREET R/W ........ ... FT -
COMP. PLAN ST. R/W ........... XV-
C] YES [3 NO
DEFICIENCY THIS PROPERTY
Valuation
0
BY
BY
0 YES 13 NO
No.
Plan Check No ......... ... .......
BUILDING
a n 0,
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENT110N
APPLICATION APPROVAL
THIS PERMIT
This application IS not a permit Until
AUTHORIZES
signed by the BUilding official or his Dep-
ONLY THE
uty; and fees are paid, and receipt is ac-
WORK NOTED
Imowledged in space provided.
INSPECTION
RE
DIREC�TORWS SIGN HE
DEPARTMENT
;DA
CITY or,
EDMONDS
PR 6-1101
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