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740551
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NEW
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' SITE IS LOCATED IN THE CITY
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NON-RESIDENTIAL
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I hereby acknowledge that I have rend this application; that the In-
tlon given le correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and elate laws regu•
ATTENTION
APPLICATION APPROVAL
lath. conatructloa; and In doing the work nUth.1l..d thereby, no person
will be employed Ia vlola km of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
r,lating to Workmen's Compensation INuratece.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is Be
shall be completed In alocty day,; MOVED -IN BUILDINGS nhall be cont-
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NOTE: Applicant Subject to Plan Check Fee
775-2525
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Any eanslrurtlon on the public domain (curbs, sidewalks, drlvewvs,
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n—queer, .11.) .111 require Rep Nate permission.
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TOTAL AMOUNT DUE
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BY
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STATE LICENSE NUMBER
CITY LICENSE NUMBER I I I
formation given Is correct; and that I are the owner, or the duly author.
Ized agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
SPECIAL INSPECTOR REpUIREU
GROUP
I I.neni Deecrl¢tma of Party (Show
Below
or Attach Four Copier)
REMARKS
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BUILDING
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EXCAVATION OR FILL
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TOTAL AMOUNT DUE
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FIRE ZONE I TYPE OF CONSTRUCTION
__'Zr_Z13TJj PROVED
YES ❑ NO
formation given Is correct; and that I are the owner, or the duly author.
Ized agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
SPECIAL INSPECTOR REpUIREU
GROUP
NEW
ADD
RESIDENTIAL
NON-RESIDENTIAL
DEMOLISH
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❑
GAB
LINE
DIGN
RETAINING
WALT
[3 YES E3 NO
PLAN CHECKED BY
REMARKS
(OCCUPANCY
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
I I
ONLY THE
WORK NOTED
ALTER
shall be completed In bluely days; MOVED -IN BUILDINGS shall be Som-
E
❑
(ENCS
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SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
Dl TOR'BGNAT -v
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ORFILL
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CITY OF
EDIVIONDS
REPAIR
❑
INSPISOVE
❑
SWIM
POOL
775-2525
1
NUMBER OF STORIES NUMBER OF
INSPECTOR
marquees, etc.) will regee separate permission.
DWELLING
UNITS
NATURE OF WORK TO BE DONE _ _
I
Valuation I
Fee Receipt No.
Plan Check No .....................
i
BUILDING
(yr
Y PROPOSED USE
PLUMBING
U
aPLOT
PLAN (Indla¢[e Hulidpl6- b \ b In6 street.)
HEAT & GAS LINE
f"�! .,yo
FENCE
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1`i n
I hereby acknowledge that I have rend this application; that the In-
I 0
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formation given Is correct; and that I are the owner, or the duly author.
Ized agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
laDng constructlou; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Waehlogton
THIS PERMIT
This application is not a permit until
relating toWorkmen's Compensation Insurance.
AUTHORUZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In bluely days; MOVED -IN BUILDINGS shall be Som-
knowledged in space provided.
,,Ctcd In six menthe.)
:>
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
Dl TOR'BGNAT -v
•l
I
DEPARTMENT
f
CITY OF
EDIVIONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
775-2525
This Permit r rti work to be done on private property ONLY.
Any eanetructlan an the public domain (curbs, sidewalks, &I—Y.,
INSPECTOR
marquees, etc.) will regee separate permission.