750317.pdfE]RESIDENTIAL
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PLAN CHECK D H
THIS SITE IS LOCATED IN THE CITY
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Applicant 11111
USEDp(�'- 'n PERMIT 750317
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PERMIT APPLICATION
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NAME (OR NAME OF BUHINESS)
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HOULD BE CODED 31.04.
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Legal Description of Property (Show Below or AltaCn Four Copies)
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PLOT PLAN ,mg 9etbnoke, abutting .mast.)
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E]RESIDENTIAL
GA8
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PLAN CHECK D H
THIS SITE IS LOCATED IN THE CITY
❑ NON-RESIDENTIAL
❑ BIONf
OF EDMONDS. LOCAL SALES TAX
❑ ADD
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AR
HOULD BE CODED 31.04.
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NATURE OF WORK TO BE DONE('
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Fee Receipt No.
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BUILDING
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PLUMBING
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PLOT PLAN ,mg 9etbnoke, abutting .mast.)
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
I hereby acknowledge that I have read t611 application; that the In-
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form it Elven is correct; and that I am the owner, or the duly author-
Ized 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
will be employed In violation of the Labor Cede or the State of Washington
THIS PERMIT
This application Is not a permit until
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relating to Workmen's Compensation lmurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DE31OLITIONS which
ONLY TILE
Uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; DIOVED-IN BUILDINGS shall be com-
WORK NOTED
knowledged In space provided.
pleted In six month$.)
S16NATU1 (OWNER OR AGENT)
DATE SIGNED
INSPECTION
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DEPARTMENT
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CITY OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fre
775-2525
This Permit Carers work l0 Ira done on private property ONLY.
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Any const ruetlon nn itis Pablle ve
dmm�ln tenths, sidewalk., delwale,
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