740448.pdfBUILDING
DEPARTMENT
PERMIT APPLICATION
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°NE NUMBIER 740448
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NAME (OR NAME OF BUSINESS)
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PERM1tlSIHLE ACTUAL
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TELEPHONE NUMBER
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NAME
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ADDRES
REMARxeDriveway slopes not to exceed those
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_A/ 1O'YES [] NO
IREDANCY GROUP
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THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
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STATE LICENSE NUMBER
_A/ 1O'YES [] NO
IREDANCY GROUP
rOCCUP" J /
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
T/ n.tJ aX c, /%73
Fee
No.
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RESIDENTIAL
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_A/ 1O'YES [] NO
IREDANCY GROUP
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THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
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T/ n.tJ aX c, /%73
Fee
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UMBER OF STORIES
NUMBER OF
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DWELLING
DEMOLITION
UNITS
%
_A/ 1O'YES [] NO
IREDANCY GROUP
rOCCUP" J /
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
T/ n.tJ aX c, /%73
Fee
No.
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Plan Cheek No.. ...................
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BUILDING
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PROPOSED USE
PLUMBING
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PLOT PLAN (Indicate Building setbacks, abutting street.)
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DISE
I hereby acknowledge that I have read this application; that the in--
formatien given Is correct; and that I am the owner, or the duly author.
[zed agent of the owner. I agree to comply with city and stale laws regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
i
will be employed In violation or the Labor Code of the Stale of Washington
THIS PERMIT
This application ie not a permit until
rotating to Workmen's Compensation Insurance.AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITION8 which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
-
shall be Completed In ninety days; MOVED -IN BUILDINGS shall be com.
knOWledged in space provided.
Pitted In six month..)
_
BIONATURE IOWN.R OR AGENT)
DATE SIGNED
INSPECTION
D CTOA'S 91 NAT E
y
�CITY
DEPARTMENT
- i
OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
— _
775-2525
Title Permit covers work to be dune on private property ONLY.
Any cone, rurtlon on the public domain (,.,be, sidewalks, drirewars.
u,., rilur•rs, Ht WII rry ulr,• nrpuru lr• prrud.elon. _
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