750403.pdf-
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DEPARTMENTApplicant
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PERMIT
NUMBER 750403
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PERMIT APPLICATION inside Heavy Lines
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PLANNII�NG DEPT. APPROVAL DATE
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STATE LICENSE NUMBER CITY LICENSE NUMBER
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Legal D/gscription of.tPr�operty (Show Below or Attach Four Copies)
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❑ NEW RESIDENTIAL L'. E
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I hereby acknowledge that I have reed nolo application; that the In.
TOTAL AMOUNT DUE
formation glven le correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree to comply with city Ind aLLt, law. regu.
latmg comtructlun; and In doing the work authorized thenby, no person
ATTENTION
APPLICATION APPROVAL
will be employed In violation of the Leber Code of the elate of Washington
THIS PERMIT
relanag m oramen's Compensation Insurance.
This application is not a permit until
NOT ermit Limit One Year (Except DEM011TIONe
AUTHORIZES
ONLY THE
signed by the Building Official or his Dep-
which
enall ompleled in alnety dey ' MOVED -IN BUILDINGS shall be care-
WORK NOTED
uty; and fees are paid, and receipt is ac-
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knowledged in space provided.
SIG URE ( NER AG NT) PATE SIGNET
INSPECTION
DEPARTMENT
11
CITY OF`
MR,KS11,
EDMONDS
NOTL Applicant Subject to Plan Check Fee
775-2525
DATE
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This Permit covers work to bedone on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
ORIGINAL - File YELLOW - In;peclor
marquees, etc.) will require separate permission.
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BUILDING DEPARTMENTZONe / �� NUMBER
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PERMIT APPLICATION Inside Heavy lines ,DB
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relating to Workmen's Compensation Ineurenca.
THIS PERMIT
This application
pp ication is not permit Until
NOTE: Permit Limit One Year (E:cept DEMOLITIONS which
AUTHORIZES
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shall be completed In ninety day.; BIOV7 BUILDINGS shall be com.
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PLANNING DEPT. AP ROYAL DATE
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EDMONDS
NOTE: Applicant Subject to P/m Clreck Fee
COMP. PLAN ST. R/ FT. FT. iJ FT.
DATE
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REMARKS Driveway slopes not to exceed those
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formation given is correct; and that I are the owner, or the duly author,
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OCCUPANCY OCCUPANT
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NUMBER OF STORIES
NUMBER OFDWELLUNITSING�NATV
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1 hereby acknowledge that I have read this application; that the In-
TOTAL AMOUNT DUE
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formation given is correct; and that I are the owner, or the duly author,
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fired agent of Iho owner. I agree to comply withcityand slats laws "re-
lating construction; and In doing the work authorized thereby, no person
ATTENTION
APPLICATION APPROVAL
will be employed In violation of the Labor Code of the state of Waahlogton
relating to Workmen's Compensation Ineurenca.
THIS PERMIT
This application
pp ication is not permit Until
NOTE: Permit Limit One Year (E:cept DEMOLITIONS which
AUTHORIZES
ONLY THE
signed by the Building Official or his Dep -
shall be completed In ninety day.; BIOV7 BUILDINGS shall be com.
WORK NOTED
uty; and fees are paid, and receipt Is ac-
pleted In ala months.)
knowledged in apace provided.
IGNgTU WNRR A
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DATE SI NE
INSPECTION
DEPARTMENT
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CITY OF
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EDMONDS
NOTE: Applicant Subject to P/m Clreck Fee
775-2525
DATE
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This Permit coven work to be done on private property ONLY.
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Any construction on the public dome in (curbs, sidewalks, driveways,
ORIGINAL -File YELLOW - Inspector
marquees, etc.) will require separate permission,
PINK - C:'m.v COLD - A .-.,