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This application is not a permit until
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knowledged In apace provided.
TOTAL AMOUNT DUE
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formation given le correct; and that I non the owner, or the duly author-
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ATTENTION
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THIS PERMIT
retail., to Workmen's Compensation Insurance.
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10 V Y,)17
APPLICATION APPRCIi ✓
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged In apace provided.
TOTAL AMOUNT DUE
Plan Check Nn .....................
L
formation given le correct; and that I non the owner, or the duly author-
ized agent of the owner. I agree to comply with city and elate law. rag.-
ATTENTION
BUILDING
W PROPOSED USE
wlil be employed In violation of the Labor Code of the Slate of Washington
THIS PERMIT
retail., to Workmen's Compensation Insurance.
AUTIIOIIIZE15
PLUMBING
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ehali be completed In Nuety days; MOVED -IN BUILDINGS shall be mm-
Z PLOT PLAN (Indicate Building setbacks, abutting street.)
HEAT A GAS LINE
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DEPARTMENT
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CITY OF
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EDMONDS
NOTE: Applicant Subject to Plan Check Fee
SIGN
775-2525
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PRE -MOVE INSPECTION
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10 V Y,)17
APPLICATION APPRCIi ✓
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged In apace provided.
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given le correct; and that I non the owner, or the duly author-
ized agent of the owner. I agree to comply with city and elate law. rag.-
ATTENTION
luting construction; and In doing the work authorized thereby, no person
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THIS PERMIT
retail., to Workmen's Compensation Insurance.
AUTIIOIIIZE15
NOTE: Permit Limit One Year (Except DEMOLITIONS which
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WORK
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ehali be completed In Nuety days; MOVED -IN BUILDINGS shall be mm-
plcted In at. months.)
IIGNATU1tE (OWNER Oil ENT) DATE SIGNED
INSPECTION
57 'i- 7
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
775-2525
This !'ernilt cutvro work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, dri—ays,
mnrqueee, etc.) will require separate permlaslon.
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10 V Y,)17
APPLICATION APPRCIi ✓
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged In apace provided.
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SHOULD BE CODED 31.04.
ADD ❑•DEMOLISH ❑ yAiy NING
REMARKS
ALTER ❑ EXCAVATE FENCE
OR FILL (.........3..........Fl.)
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NUMBER OF STORIES NUMBER OF
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SWIMMING POOL
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PRE -MOVE INSPECTION
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EXCAVATION OR FILL
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TOTAL AMOUNT DUE
Ihereby acknowledge that I have read this application; that the In-
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formation given is correct; and that I =the owner, or the duly author-
Ited agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
laling construction; and In dolug the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS PER511T
This application is not a permit until
,
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORM NOTED
uty; and fees are paid, and receipt is ac
shall be completed In nicety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
pleted In six months.)
d10NATUItE (O{VNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
DIRECTOR'S ,tl GNAT _ _
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-
CITY OF
EDhfONDS
DATE
NOTE: Applicant Subject to Plan Cbeck Fee
775-2525�-
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This 1lermlt raven work to bo done on private property ONLY.
Any conslruellon on the public domain (curbs, sidewalks, driveways,
INSPECTOR
marquees, etc.) will require separate perndssinn.
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