720209.pdfA,
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BUILDING DEPARTMENT
PERMIT APPLICATION
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OF BUSINESS)
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NEW
ADD
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REPAIR
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Applicant M
Inside Heavy Lines
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RESIDENTIALAS El L
LINE
NON-RESIDENTIAL ❑ SIGN
❑RETAINING
DEMOLISH WALL
EXCAVATE ❑ FENCE
OR FILL (I ....... ..z_........ Ft.)
PRE -MOVE �''j SWIM
I { INSP. I l POOL
DWELLING
UNITS
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I hereby acknowledge that I have read this application; that the In-
formation given is correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu-
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance,
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN DUIIAINGS shall be com-
pleted In six months.)
NO.: PERMIT
NUMBER
%J
EXISTING STREET R/W ............FT.
COMP. PLAN ST, R/W ............IT,
720209
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DEFICIENCY THIS PROPERTY
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CITY OF Et.f,iCid i`.3. 1.rN;?1_ SALES
Valuation Fee Receipt No.
Ma Check No. ........ ...........
HUILDIN6 15**1170 rod P:�.t7C
PLUMBING
HEAT d: OAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE . a
ATTENTION APPLICATION APPROVAL
THIS PERMIT This application is not a permit until
AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ac-
knowledged in sgace provided.
"TUBE (OWNER OR AGENT) DATE SIGNED INSPECTION
,i DEPARTMENT
Y CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR M1107
Thin Permit covers work to be done on private property ONLY.
An7 construction on the public domain (curbs, sidewd drivewge,
marquees, etc.) win require separate permission.
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Foundation
Plumbing (Partial)
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Frame
Furnace &Fuel Lines
Final
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RECORD OF INSPECTIONS (,
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Drainage
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Parking
Lands capi ng
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