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ARKS
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TYPE CONN ECTIO
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❑ ADD
RETAINING
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WALL
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wlll be employed In YlolaUoa of the Labor Code of the Stale of Washington
THIS PERMIT
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HEAT S, GAS LINE
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ONLY THE
.hall be completed In ninety days; blOVED-IN BUILDINGS shall be com-
FENCE
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SIGN
IGNATURE (OWNER OR AGENT)
RETAINING WALL
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SWIMMING POOL
i hereby acknowledso that I have rend this appllcallon; that the In
TOTAL AMOUNT [
[ormntlon given Is correct; end that I sin the owner, or the duty author-
OCCUPANCY
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ATTENTION
iating conetrucllcn; end In doing the work authorized thereby, no person
LOAD
wlll be employed In YlolaUoa of the Labor Code of the Stale of Washington
THIS PERMIT
relaling to Workmen's Compensation Insurance.
AUTHORIZE'
NOTE: Permit limit One Year (Exeopt DEMOLITIONS which
ONLY THE
.hall be completed In ninety days; blOVED-IN BUILDINGS shall be com-
WORK NOTE(
Pleted In six month..)
INSPECTION
IGNATURE (OWNER OR AGENT)
DATE SIGNED
pEPARTM EN
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CITY OF
EDMONDS
NOV.: Applicant ,Subject to Plan Check Fee
775-2525
This Permit covers work to be done on private property ONLY,
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
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VALUATION FEE
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
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wledged in space provided.
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WORK REQ'D
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BUILDING DEPARTMENT Applicant Fill
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REMARKS
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NUMBER OF STORIES NUMBER OF
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I hereby acknowledge that I have read this application; that the in
DUE AMOUNT DUE
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iz
Legal Descriptlo; of Prop rty (Show Below or Attach Four Copies)
STREET AND/OR UTILITY ❑ YES I
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lzedagent of the owner. I agree to comply with city and stale lava re--
ATTENTION
WORK REQ'D
❑ NO
laung construction; and m doing the work sutborlsed thereby, ao person
will beemployed In violation or the Labor Cade of the stale at Washington
-- - - -
This application is not a permit until
UNDERGROUND
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SIGNATURE (OWNER OR AGENT) DATE SIGNED
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SEPTIC SYSTEM
APPVD BY CITY ENG.
❑ NO
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DATE
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775-2525
REMARKS
This Permit covers work to be done on private Property ONLY.
is
ORIGINAL -File YELLOW -Inspector
Any construction on the public domain (curbs, sidewalks, driveways,
W
J
METER SIZE SERVICE SIZE CLEARANCE CHECKED BYE
PINK - Owner GOLD - Assess,r
-
E
REMARKS
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FIRE ZONE TYPE OF CONSTRUCTION CODE
❑ NON-RESIDENTIAL
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RETAINING
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REQUIRE DSPECTOR AREA OCCUPANCY OCCUPANT
GROUP LOAD
❑ ALTER EXCAVATE
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WALL
FENCE
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❑ YES NO
PLAN CHECKED ev
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THIS SITE IS LOCATED IN THE CITY
F-
w
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OF EDMONDS. LOCAL SALES TAX
REPAIR ❑ PRE -MOVE
INSP.
OSWIM
POOL
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SHOULD BE
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REMARKS ) 1
NUMBER OF STORIES NUMBER OF
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DWELLING
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NATURE OF WORK TO BE DONE
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VALUATION FEE
PROPOSED USE
PLAN CHECK
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NO.—
IL PLOT PLAN INDICATE BUILDING SETBACKS,
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BUILDING
N - -
PLUMBING
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m
HEAT & GAS LINE
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FENCE
SIGN
•
RETAINING WALL
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SWIMMING POOL
I hereby acknowledge that I have read this application; that the in
DUE AMOUNT DUE
/ : '.;�
I
formation given Ie correct; and that i am the owner, or the duly author-
lzedagent of the owner. I agree to comply with city and stale lava re--
ATTENTION
APPLICATION APPROVAL
laung construction; and m doing the work sutborlsed thereby, ao person
will beemployed In violation or the Labor Cade of the stale at Washington
THIS PERMIT
This application is not a permit until
,
rclatla6 to Workmen's Compensltton Ineurence.
AUTHORIZES
elgned by the Building Official or his Dep-
-
NOTE: Permit Limit One Year (Except which
ONLY THE
uty; and fees are paid, and receipt is Be-
DINGS hall
nhall be completed In Nnety OnYa: MOVED -IN BUILDINGS shall be cam-
WORK NOTED
lmowledged in apace provided.
pleled In six menthe.)
INSPECTION
SIGNATURE (OWNER OR AGENT) DATE SIGNED
DEPARTMENT
DIRECTOR'S SIGNATURE
-
CITY OF-
EDMONDS
DATE
NOTE: Applicant Slfbject to Pan Check Fee
775-2525
This Permit covers work to be done on private Property ONLY.
ORIGINAL -File YELLOW -Inspector
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
PINK - Owner GOLD - Assess,r
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