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BUILDING DEPARTMENT Applicant t=ill
ZONE PERMIT
750401
PERMIT APPLICATION Inside Heavy Lines
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LEGAL LOT
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MAILIN DDR 55 '•/ ��
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TELEPHONE NUMBER
PLANNING DEPT. APPROVAL DATE
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STREET AND/OR UTILITY El YES
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WORK REQ•D ❑ NO
UNDERGROUND ❑ YES
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TYPE OF N CODE
NON-RESIDENTIAL ❑SIGN
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❑ DEMOLISH RETAINING
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PLAN ClEC ED Y THIS SITE IS LOCATED IN THE CITY
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REPAIR ❑ INSP.
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NUMBER OF STORIES
NUMBER OF
DWELL NGTLs �•
UNITS J'
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NATURE F WORK TO BE DONE
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PROPOSED USE
VALUATION FEE
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PLAN CHECK
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PLOT PLAN INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
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HEAT &GAS LINE
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FENCE
SIGN
RETAINING WALL
SWIMMING POOL
I hereby acknowledge that I have read this application; that the In-
TOTAL AMOUNT DUE
formation given IS correct; and that I ane the owner, or the duly author.
Ized agent of the owner. I agree to comply with city and state laws regu.
lating Conetructmn; and In doing the work authorized thereby, no person
ATTENTION
APPLICATION APPROVAL
will be employed In violation Of the Labor Code of the Stale of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.AUTHORIZES
This application Is not a permit until
NOTE: Permit Limit One Your (Except DEMOLITIONS which
ONLY THE
signed by the Building Official or his Dep -
a 11 be epmID4q1cled In ninety days; MOVED -IN BUILDINGS shall be cone.
.ORK NOTED
uty; and fees are paid, and receipt is ac -
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INSPECTION
DEPARTMENT
ltnowledged in apace provided.
R R•5 SIG AT RE
SIGNA7{yR
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V ER OR AGENTI
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DA E NED
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CITY OF
EDMONDS
775-2525
GATE
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NOTE: Appl' ant/Si bject to Plan Check Fee
This Permit covers r oto be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
ORIGINAL - File YELLOW - Inspector
marquees, etc.) will require separate permission.
PINK - GOLD - P
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