710382.pdfC-
FNG DEPARTMENT
APPLICATION
ME OF INESS)
CNF
U
8
p-71 -
NEW
ADD
ALTER
REPAIR
Applicant FIU
Inside Heavy Liles
OAS fi tip
RESIDENTIAL � LINE � `i
NON-RESIDENTIAL SIGN
DEMOLISH El WALL
ALL
EXCAVATE ❑ FENCE
OR FILL (.......... .......... Ft.)
FPRE-MOVE SWIM
I INSP. POOL
DWELLING
UNITS
ahl:
G'i
EXISTING STREET R/W ............FT.
COMP. PLAN ST. R/W ............FT.
I hereby acknowledge that I have read this application; that the In-
formation given 1s 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
Year DEMOLITIONS which
aballemdi nineydays;VED�BUILDNGS shall be com-
pleted In six months.)
'.c 3— //
NOTE: applicant Subject to Plan Check Fee
I This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) wilt require separate permission.
YES ❑ NO
Plan Check No .....................
BUILDING
PLUMBING
HEAT do GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
TIIIS PERMIT
AUTHORIZES
ONLY TIM:
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 0-1107
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; fees are paid, and receipt is ac-
know l;d, in aco Rovi
D
DATE M'
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