700268.pdfFI
DING DEPARTMENT
MIT APPLICATION
(OR NAME OF BUSINESSS))
MAILING ADDRESS
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IBM
ADDRESS
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-CITY
NEW
ADD
ALTER
REPAIR
Applicant FM
Inside Heavy Lines
RESIDENTIAL OAS
LINE
NON-RESIDENTIAL ❑ SIGN
RETAINING ❑
DEMOLISH WALL
EXCAVATE FENCE
OR FILL I ........ .z......... Ft•)
PRE -MOVE SWIM
I l INSP. I I POOL
DWELLING /
tl UNITS
I hereby acknowledge that I have read thin application; 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 lawn regu-
lating construction; and In doing the work authorized thereby, no person
will be employed In vlolatloa of the Labor Code of the State of Washington
relating to Workmea's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted in six months,)
A
KISTING STREET R/W ............FT.
COMP. PLAN ST, R/W ............FT.
■ N M
Plan Check No. ........ ...........
BUILDING
FENCE
SIGN
RETAINING WALL
�'.p_n .. t '�•
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
PM 700268
IVACANT SITE
❑ TES )alp'
DEFICIENCY TRIG PROPERTY
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IV LL,
Fee
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❑ NO
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TOTAL AMOUNT DUE {
ATTENTION APPLICATION APPROVAL
THIS PERMIT This application is not a permit until
AUTHORIZES signed by the Building Official or his Dep- 4
ONLY THE
WORK NOTED uty; and fees are paid, and receipt to Bea
ltnowledged in space provided
INSPECTION
761 CITY OF w
EDMONDS DATE / \
{ NOTE: Applicant Subject to Plan Check Fee PR 6-1107 —
�(, J/ �u
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (carbn, sidewalks, drlvewl7ss FILE
marquees, etc.) will require separate permission.