750444.pdfP -
NUSE UMBIR
REMARKS
BUILDING DEPARTMENT Applicant Fill
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PERMIT APPLICATION Inside Heavy Lines
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NATURE OF WORK TO BE DONE
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NAME
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REMARKS
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❑ NEW CK RESIDENTIAL � LIr1E
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THIS SITE IS LOCATED IN THE CITY W
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PLOT PLAN INDICATE BUILDING SETBACKS,
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SWIMMING POOL
I hereby acknowledge that I have read this application; that the In-
TOTAL AMOUNT DUE
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formation given Ie correct; and that I am the owner, or the duly author.
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Red agent of the owner. 1 agree to eomply with city and slate lawarogu-
lallor conetructlon; 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 Washington
THIS PERMIT
!
relating to Workmen'. Compe... tion Ina—ce.
This application Is not a permit until
NOTE: Permit Limit One Year (Eseepl DEMOLITIONS which
AUTHORIZES
ONLY THE
Signed by the Building Official or his Dep -
.hall be Completed In m.ItY days; MOVED -IN BUILDINGS shall be com-
WORK NOTED
uty; and fees are paid, and receipt is so
acted In sls ...the.)
Imowledged in space provided.
SIGNATURE (OWNER OR AGENT
INSPECTION
'
IDATE;,IGNED
�fDEPARTMENTIRECTO
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CITY OF
SIGN E
EDMONDS
NOTE' Applicant Subject to Plait Check Fee
775-2525--
DATE
zThis
Permit covers work to be done onprivate property ONLY.
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Any construction on the public domain (curb's, sidewalks, driveways,
ORIGINAL - Pdc YELLOW • Inspector
marquees, etc.) will require separate permission.
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