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UILDING DEPARTMENT ApplltsBtFlll
PERMIT APPLICATION InBide Heavy LiBea
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u RESIDENTIAL ❑ OA9
LINE
❑ NON-RESIDENTIAL ❑ BION
RETAHQINO
❑ aEMOLulH ❑ WAT.T.
❑ExcwvwTE ❑ ONCE
OR FILL (__._y..._.Ft.)
PRE-3iOVE �''7 SWIM
1 l INBP. I l POOL
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I heroby acknowledie that I have read thb nDDhcatloa; that the ln-
tormatlon alvw L correct; and that I nm the owner, or the duly auWor-
Ized ¢Seat o[ the owner. I nttree to comply with Illy and state ]aws rosu-
lntlni wnrtructloa; Sad In dotal the work aulhorlud theroby, ao Denoa
will be employed Ia violation of the Labor Code of the Stale of WaahW[toa
rotating to Workmen's Compenzatloa Imutmoe.
NOTE: Permit Limit One Year' (Escept DEMOLITIONS whlob
shall be completed In ninety days; MOVED -IN BOII.DINOa shall be com-
pleted Ia elz months.)
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NOTE: Applicant Subject to Plan Check Fee
This Permit eovero work to be dose ao private property ONLY.
AAy coastructloo on the pnhllo domNa (sorbs, sidewalks, drlvavals,
maryuees, eta.) wlB regWre separate permission.
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P NO.: PERMIT
NUMBER �90461
EXIBTINO STREET R/W ...-.._...FT.
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❑ NO
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EXCAVATION OR
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DEFiOIENOY THIS PROPERTY
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Valuation � Fee
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nTTExTIox APPLICATION APPROVAL
TIBB PEIt1+tPl' This application ie�not a perffit until
euTBonlzFs signed by the Building Official or his Dep-
ONLY Tl[E
WOIIH NOTED uty; and fees are paid, and receipt is ac-
knowledged in apace provided.
nYBPECTION
DEPARTMENT
CITY OF
EDMONDS
PB 6.1107
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RECORD' OF -''INSPECTIONS
k, , ( 11 , Date Passed f
s . iILL _IF I.I� Foundation--=--�� I ;,,1.�t. !
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;Furnace &Fuel Line I
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19 I 1 I rl( , , +If, s _. i �.( ;'s i(f i ,t>'Date`.Passed f III I). t.
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