700461.pdfCr
BUILDING DEPARTMENT Applicant MR
PERMIT APPLICATION I Inside Heavy Lines
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NAME
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STATE LICENSE D
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KIRESIDENTIAL ❑ LAS LINE
NON-RESIDENTIAL ❑ SIGN
❑RETAINING
DEMOLISH L_f WALL
EXCAVATE FENCE
OR FILL (........ ••x......... Ft.)
PRE -MOVE SWIM
INSP. POOL
DWELLING
UNITS
I hereby acknowledge that I have read this 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 laws regu-
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington
relating to Workmen'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.) i
NOTE: 1461plicant Subject to Plan Check Fee
This Permit coven
work to
be done
on private properly ONLY.
Any construction on
the public
domain
(curbs,
sidewalks, drivewayst
marquees,
etc.) will
require
separate
permission,
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1
b
h
t
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EXISTING STREET R/W ............ FT, DEFICIENCY THIS PROPERTY '
1
COMP, PLAN ST. R/W ............FT. ....... ...•.FT. p 1
REMARKS 6 i
FIRE ZONE I TYPE
❑ YES ❑ NO
Plan Check No. .................
il04Ali`.(e
7A11�4=Etil�:
HEAT d: GAB LINE
FENCE
SIGN
RETAINING WALL
F. •..s
Is)A) (s)A40ISNI
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
ED51ONDS
Pn 6-1107
PERMIT 70046 1
NIILIBER
APPLICATION APPROVAL" [ '
This application is not a permit until i !,
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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