690124.pdfPOSTED ON KROLL MCP NO-: PERMIT
BUILDING DEIARTMINT Applicant Fill NUMBER 690124
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inside Heavy Lines JOB ADDRESS
..PERMIT. .APPLI T CATION
... 1. 1�. . . �w MIR WWRQ%
C4 NAME
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ADDRESS.Z A
74:A�- (b - bilo"�
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R101
RESIDENTIAL
M
GAS
IMF
NEW
E]
NON-RESIDENTIAL
SIGN
RETAINING
WALL
ALTER
DEMOLISH
EXCAVATE
OR VILL
El
FENCE
( x Ft.)
.......... .. .......
REPAIR
El
PRE -MOVE
INSP.
SWIM
POOL
:S
NUMBER OF
DWELLING
UNITS
56
I hereby acknowledge that I have read this MPPIIcatl0n; that 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
relating to Workmen's Compensation Insurance.
NOTE
.��it Limit One Year (Except DE5101ATTIONS which
anall-Ne- compl5ted in ninety days; MOVED -IN BUILDINGS shall he com-
,tieted. in wxAonths.)
NOTE: Agficant Subject to Plan Check Fce
_jys'-permit coven work to be done on Private property ONLY.
Any construction on the public domain (curbs, sidewalks, driverways,
marquee*, eW.) will require separate permission.
I
[I YES
�Ij
EXISTING I STREET R/W DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R/W .......... FT.
[j YES r] No
[j YES /-Fkl NO
All cnnstruction subject to site inspections
4-4-69
Plan Check No ............
BUILDING
PLUMBING
HEAT & GAS LIKE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTEIff][ON
THIS FE101IT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 0-1107
047
G
Z
14
Fee I Receipt No.
I � , o 0 10 70 �-) G
APPLICATION APPROVAL
This application is not a pem-dt until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
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