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PLANNING DEPT. APPROVAL DATE:
TELEP ONE NUMSEA
STREET R/1V
EXIBTIN6 STREET RJW ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMAKES
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Plan Check No .....................
RESIDENTIAL
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PROPOSED USE
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(] YES ❑ NO PER—.1 rvumoert
PLANNING DEPT. APPROVAL DATE:
TELEP ONE NUMSEA
STREET R/1V
EXIBTIN6 STREET RJW ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMAKES
4v 1
YES [I NO
0 YES El NO
OCCUPANCY OR UP
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAH
Plan Check No .....................
RESIDENTIAL
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NEW
PROPOSED USE
PLUMBING
❑
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;UMBER OF STORIES
NUMBER OF
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PRE-I/OVE INSPECTION
DWELLING
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EXCAVATION OR FILL
UNITS
TOTAL AMOUNT DUE
YES [I NO
0 YES El NO
OCCUPANCY OR UP
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAH
Plan Check No .....................
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BUILDING
PROPOSED USE
PLUMBING
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PRE-I/OVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
1 hereby acknowledge that I have rend this application; that the In-
formation given is correct; and that I am the owner, or the duty author -
with city and State IBWe rogu-
APPLICATION APPROVAL
teed agent of the owner. I agree to comply
lating construction; and to doing the work authorised thereby, no Perron
Labor Code of the State of Washington
ATTENTION
THIS PERMIT
This application is not a permit until
Will be employed to vlolatloo of the
retailing to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
ONLY THE
uty; and fees are paid, and receipt is me -
NOTE: Permit Limit One Year (Eeeept DEMOLITIONS which
WORK NOTED
In space provided.
shall be completed in mnetY days: MOVE -1- -----GS hall be win•
Itnowledged
pleled in Me months.)
SIGNATURE (OWNER Oft AGENT)
DATfl elONED
INSPECTION
DEPARTMENT
DIR OR'8 ` NAT
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CITY ON
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Applicant Subject to Plan Check Fee
EDBIONDS
NOTE:
Pn 0-1107
This Permit coven Work to be dans on private property ONLY.
driveways.
FILE
Any Construction on the public domain (.-be, sMewalke.
mnrVueea. etc.) will reamre separate per d. -Ion.