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BUILDING DI
PERMIT API
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,y,""��-'- Legal DescrlDtlon of Property (Show Below or Atte
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NEW � u SION L
A ADD DEMOLISH � FENCE � i3 �-I^ ('
� ALTER RESIDENTIAL NIl1iBER OF
,� I DWELLING
REPAIR 1f�I NON-RESIDENTIAL UNITa t
I hereby acknowledge that I have read this applicatloa; that the fa-
iormatlon gives Ie correct; and that I am the owner, or the duly anmor-
lsod agent oT the owner. I agree to comply with city aad state laws regu-
latln6 coaetrucUon; and 1a dolaB the work authorised thereby, no pereoa
will be employed in violation o[ the Labor Codo of the State of Washington
relatlnB to Woticmea's Compeneatloa Imurance.
(Except Demolitlone which shall
NOTE: Permit Llmi One Year be completed 1n ninety days.)
IIONAT HR ) DATE 8 NED
NOTE: A(]plicaut Subject to Plan Check Fee
Thle Permit covers
work to
be done
on Drlvate Property ONLY.
Any mastractloa m
the pabila
domain
(earbe,
etdewnike, driveways,
msuyuees,
etc.) will
regdre
separate
perndsslan.
ad
�rr
BUILDING
1 VALUATION
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ATTENTION
THIS PERMIT
AUTHOBIZEB
ONLY THE
WORA NOTED
INSPECTION
DEPARTMENT
OITY OF
EDMONDS
PA 8-1107
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APPLICATION APPROVAL
This application is not a• permit until
signed by the Director of Bullding Inspec-
tion, or hie deputy; and Pees are paid, and
receipt is aclrnowledged in space provided.
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