750353.pdfBUILDING DEPARTMENT Applicant Fill
USE
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PERMIT
NUMBER 750353
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I hereby acknowledge that I have read this nDDticatlon; that the tn-
TOTAL AMOUNT DUE
formation given Is correet; and that I am the owner, or the duly author-
Ixed agent of the owner. I agree to oomply with city and dale laws reg--
the authorised thereby, no parson
ATTENTION
APPLICATION APPROVAL
lating Construction; and In doing work
will be employed in violation of the Labor Code of tba Stale of Washington
THIS PERMIT
This application is not a permit until
-
relating to Workmen's Cempematton Imuranoe,
AUTHORIZES
signed by the Building Official or his Dep
-
NOTE: Permit Limit One Year (Except DEMOLITIONS whleh
ONLY THE
Dty; and fees are paid, End receipt is ac-
ehnll be camplated In ninety days; MOVED -IN aDILDINOB shall be cam-
WORK NOTED
Imowledged in space provided.
pleted In six monlhe.)
INSPECTION
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SIGNAT//Uj/:///E/I�O W�yJN E//"/O`/A,",AGENTI DATE SIGNED
DEPARTMENT
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CITY OF
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EDMONDS
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NOTE: Applicant Subject to Plan Check Fee
775-2525
DATE
This Permit covers work to be done on private pproperty ONLY.
the domain (curbs, III (walks, driveways,
ORIGINAL - PJc YELLOW • In�,pcaor
Any construction on public
marquees, etc.) will require separate permission.
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NAME (OR NAME OF
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IRING REO'D
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❑ NEW RESIDENTIALjLINE
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REQUIRED SPECTOq AREA GROUP NCY LOOAD PANT
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ALTER ❑ EXCAVATE FENCE
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❑ YES ❑ NO
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
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-MOVE IM
❑
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1 hereby acknowledge that I have rend 161, application;; that the In.
TOTAL AMOUNT DUE
formation given Is correct; and that I am the owner, or the duly author-
Ized agent of tae owner. I agree to comply with ally and .lata law. raga-
on
ATTENTION
APPLICATION APPROVAL
lacing COnetructloo; and In doing the work authorized thereby, no pen
will be employed in violation of We Labor Code of the State of Washington
THIS PERMIT
application is not a permit until
This a pp 'I
relating to Workmen's Compensation Insuroace.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
uty: and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVEDAN BDILDIN08 shall be com-
yyORK NOTED
lcnowledged 1n apace provided.
pleled in.IX month,.)
INSPECTION
-,
SIGNATURE (OWNER OR AGENT)- DATE SIGNED
DEPARTMENT
SIGNATURE
pI R ECTO R's
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CITY OF
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EDMONOS
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•
DATE
NOTE: Applicant Subject to Plan Check Fee
775-2525
This Permitcovers WoOR therk to be done on privifft.nan Iff te property ONLY.
driveways,
ORIGINAL - File YELLOW - hupcUor '--
Any const Mariquees, Ste.) Will r quirel-separate permission
PINK - Owncr GOLD • Assessor '
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_ `750.353
RECORD OF INSPECTIONS
Date Passed
Foundation
Plumbing (Partial) —�__—
(Rough)
Frame __—
Furnace & Fuel Lines
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Final