690181.pdfBUILDING DEPARTMENT AppncantFm
PERMIT APPLICATION Inside Heavy Lines
NAME (OR NAME OF BUSINEDD)
DANIC4 R eaf TIN
KA.ILINQ ADDRESS
�3a// 7S-M AL. c%sr
OTT TELE ONE NUMBER
ADInst ✓ a 5 d? rd 17 7 5/ - 0 3 88
P NO.: PERMIT
I NUMBER
EXISTING STREET R/W ..._.»...]kT. DEFICIENCY TBID PROPERTY
COMP, PLAN ST, R/W ........ ..sr.
�e
GAS
.:,
NEW .SIGN
. • • ■RETAINING� .
■ DEMOLISH
i
ALTER
■ : a n
■ EXCAVATE
■ REPAIR ;' OL
Valuation Fee Receipt No.
%rGiVC E
Plea check No......»»......»...
PROPOSED USE
BUILDING
O PLOT PLAN (Indicate Building setbacks, abutting streets) PLUMBING
D
•s
BEAT d: GAS LINE
FENCE
SIGN
N
IRETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the in-
formation given In correct; and that I am the owner, or the duly author000
-
ised agent of the owner. I agree to comply with city and state laws regu- ATTEDMON APPLICATION APPROVAL
laUng construction; and In doing the work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington THIS PERMIT This application is not a permit until
relating to Workman'■ Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is ac-
shall be completed in ulnety days; MOVED -IN BUUMINGS shall be com• knowledged in Space provided.
pleted in six months.)
LA
I6 TURF (OWNPM O/RAG�ENT) DAT SIGNEED INSPECTION CTOR'8 NA
�/l (/ems 44 �S�f� eJ DEPARTMENT
CITY OF D T � �
EDMONDS
NOTE: Applicant Subject to Plan Check Fee PH 6-1107
This Permit coven work to be done on private property ONLY.
Any cousWction an the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission#