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PERMIT
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BUILDING DEPARTMENT
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PERMIT APPLICATION
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LOCAL SALES TAX
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REMARKS
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REPAIR PRE-MOVEBWiM
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LOCAL SALES TAX
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REMARKS
DEMOLISH
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DEMOLITION
PRE -MOVE INSPECTION
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EXCAVATION OR FILL
TOTAL AMOUNT DUE
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I hereby acknowledgo that I have rend this application; that the In-
formnllan given 1e 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 reg.-
ATTENTION
APPLICATION APPROVAL
luting constmetlon; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State Of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen'. Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Perm' Limit One Year (Except DEMOLITIONS which
ONLY THE
We. NOTED
my and fees are paid, and receipt is so -
shall be c mpleted In ninety day.; MOVED -IN BUILDINGS shall be corn-
knowledged in space provided.
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pictctl In mon s.)
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HGNATU t ( V R O GENT) DATE a ONE
INSPECTION
DEPARTMENT
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CITY OF
EDMONDS
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NO E:�Pplicantubject tG Pldn Cbeck Fe
775-2525This
Per Itbe don n prhmle property ONLY.
Any ennetr Idomain (curb., sidewalks, driveways,
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Foundation
Plumbing (Partial)
(Rough)
Frame -// »���
Furnace & Fuel Lines
Final