700046.pdfPOSTED ON KROLL MAP NO.:
PERMIT
-7
BUILDING DEPARTMENT
Applicant Fill
NUMBER
I 00046
PERMIT APPLICATION
Inside Heavy Lines
VY Lines
JOB ADDRESS
NAME (OR NAME OF BUSINESS)
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MAILING ADDRESS
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TELEPHONE NUMBE113.
7711- 7-3 910 HEIGHT
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NEW
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ADD
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NON-RESIDENTIAL
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RETAINING
WALL
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EXCAVATE
OR FILL
PENCE
( X Pt.)
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PRE -MOVE
. ...... . . ........
SWIM
REPAIR
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INSP.
El
POOL
1-7—)
DWELLING
UNITS
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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 ogres, 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't-he Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITION8 which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
ild—NATURE (OWNER-611 AGENT) DATE SIGNED
-2 tal 7,),
NOTE: Applicant Subject to Plan Check Fee
This remit coven work to be done on Private Property ONLY.
Any construction on the pubtle domain (curbs. sidewalks, driveways,
nvarquees, etc.) will require separate permission.
COMP.
[] YES
/2-
[] YES 0 NO
STREET R/W ........... FT. DEFICIENCY THIS PROPERTY
Plan check No.
LWIK0114001
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TYPE OF CONSTRUCTION STREET IMPROVED
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:CTOR REQUIRED OCCUPANCY GROUP
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Valuation Fee Receipt No.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
VVI .goo
AM OUNT
TOTAL AMOUNT DUE
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1 �§—g)l
ATTENTION
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7
APPLICATION APPROVAL
THIS PERMIT
This application is not a permit until
I
AUTHORIZES
Signed by the Building Official or his Dep-
rANTI1
I
ONLY THE
J
wonK NOTED
uty; and fees are paid, and receipt Is ac-
Imowledged in space provided.
INSPECTION
DIRECTOR'S SlObIATURP
D 1) it f
EPARTMENT
I
CITY OF
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DATE I V
EDMONDS
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PR 0-1107
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