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hereby acknowledge that I have read this application; that the In. TOTAL AMOUNT DUE �j� �` L.
on given Is correct; and )hat I em the awBer, or the duty au Nor- ✓i
nt of the owner. t agree to comply with city and stab laws neu-
ATTENTION
anstructloa; and to dales the work author):ed Nenby, as personAPPLICATION APPROVAL
employed In Violation Of the Labor Code of the State Of Washington THIS PERMIT
to workmen's Compensation Insurance. AUTHORIZES This application is not a permit until
mit Limit 0 ear (Except DEMOLITIONS which ONLY THE signed by the Building Official or his Dep -
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.hall Camp led In ninety sl MOVED -IN BUILDINGS shall be com. WORK NOTED uty; and fees are paid, and receipt is ac -
n six onlhl knowledged in apace provided.
U ( 11 Ell R A NT) DqT SIGNED INSPECTION
DEPARTMENT
RE S SIGN TUR
!� CITY OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan C leek Fee
775-2525—
This Permit eovers work to be done on private property ONLY.
Any eearnuetlon on the public domain (curbs, sidewalks, driveways, ORIGINAL - File YELLOW - (napeclnr
marquees, etc.) will require separate permission. PINK ^•: GOLD - %'
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