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1 hereby ackoowledge that [ have read thin application; that the In-
formation given H correct; and that I .m the oweer, or the duly author.
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111d .gent of the owner. 1 agree to comply with city and State laws ngu•
Iating conatnetlan; and In doing the work authorised thereby, no person
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APPLICATION APPROVAL
REQUIREMENTS
will be employed 1. violation of the Labor Code of the State of Wmbington
Laurance.
THIS PERMIT
'this application is not a pernlit until
CITY
T LEPHONE NUMBER
signed by the Building Official or his Dep
-
NOTE: Permit limit One Year (Excapt DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
.hail be completed In Neely days; MOVED -IN BUILDINGS shall be core-
PLANNING D PT. APPR VAL ADD/
ATE
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pleted 1n .Ix month..)
INSPECTION
NAME
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DIRECTO GN
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CITY OF
STREET R/W
EDMONDS
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EXISTING STREET R/W
FT. DEFICIENCY THIS PROPERTY
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775-2525
COMP, PLAN ST, R/W
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REMARKS
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2
PERMIT NUMBER
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TELEPHONE NUMBER
IS
D
SEPTIC BSYSTEM
APPVD Y CITY ENG.
C
W
2
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1
1
.TE LICENSE NUMBER
CITY LICENSE NUMBER
CHECKED BY
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II Description of Property (Sho Below or Attach Four Copies)
STREET AND/OR UTILITY ❑ YES
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WORK REQ'D ❑ NO
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SERVICE SIZE
CLEARANCE
UNDERGROUND ❑ YES
WIRING REQ'D ❑ NO
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TYPE CONNECTION VERIFIED BY
REMARKS
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PERMIT NUMBER
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OCCUPANT
LOAD
❑ ALTER EXCAVATE FENCE
❑ OR FILL ❑ (_ X_FT)
❑ YES NO
PLAN CHEC ED BY
THIS SITE
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IS LOCATED IN THE
CITY
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W
PRE -MOVE swim
OF EDMONOS. LOCAL SALES TAX
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REPAIR
REPAIR
INSP. POOL
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NUMBER OF STORIES
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1 hereby ackoowledge that [ have read thin application; that the In-
formation given H correct; and that I .m the oweer, or the duly author.
111d .gent of the owner. 1 agree to comply with city and State laws ngu•
Iating conatnetlan; and In doing the work authorised thereby, no person
ATTENTION
APPLICATION APPROVAL
will be employed 1. violation of the Labor Code of the State of Wmbington
Laurance.
THIS PERMIT
'this application is not a pernlit until
relating Io Workmen•s Compensation
AUTHORIZES
signed by the Building Official or his Dep
-
NOTE: Permit limit One Year (Excapt DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
.hail be completed In Neely days; MOVED -IN BUILDINGS shall be core-
knowledged In space provided.
pleted 1n .Ix month..)
INSPECTION
SIG UR 1QW ER R AGE
ry///qT )
DATE SIGNED
DEPARTMENT
DIRECTO GN
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CITY OF
EDMONDS
OTE: Applic ret Subject to Plan Check Fee
GATE
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775-2525
This Permit covers work to be done on private property ONLY.
driveways,
ORIGINAL - File YELLOW - Inspector
Any construction on the public domain (curbs, sidewalks,
marquees, etc.) will require separate permission.
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