740414.pdfNATURE OF WORK TO BE DONE
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BUILDING DEPARTMENT Applicant Fill
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NUMBER (L, NUMBER
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NAME (OR NAME OF BUSINESS)
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PERMISSIBLE %
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STREET R/W
APPLICATION APPROVAL
lating construcllon; and In doing the work authorized thereby, no person
EXS8TIN0 BTRE R,/)N/............FT.
DEFICIENCY THIS PROPERTY
THIS PERMIT
This application is not a permit until
NAME
COMP. PLAN 8T. r11W ............FT.
............FT.
Signed by the Building OPPtelal or his Dep-
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REMARKS
Uty; and Pees are paid, and receipt is Be
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.hall be completed In ninety days; MOVED -1N BUILDINGS shall be con-
ADDRESS
knowledged in space provided.
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SIGNATURE (OWN OR AGENT)
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223-y/ 2
775-2525
REMARKS
This Permit cncere work to be done an vrivate property ONLY.
Legal Description or Property (Shaw, Below
or Attach Four Coplea)
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TYPE CONNECTION
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PERMIT NUMBER
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REMARKS
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FIRE E I TYPE OF ONSTRUCTION STREET IMPROVED
SPECIAL INSPECTOR REQUIREDOCCUPANCY GROUP
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RESIDENTIAL E] LINE
El NEW
PLAN. HE BY
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
NON•REBIDENTIAL ❑ SIGN
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SHOULD BE CODED 31.04.
ADD RETAINING
REMARKS
E] DEMOLISH WALL
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NATURE OF WORK TO BE DONE
Valuation
Fcc Receipt No.
Plan Check Nn....... ..............
7
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BUILDING
1-16-,900
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a 06
ff
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PROPOSED USE
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PLUMBING t�(fo
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PLOT PLAN (Indicate Building .etbaeka, abutting Streets)
BEAT A GAS LINE
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FENCE
SIGN
tRETAINING
WALL
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1
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
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EXCAVATION OR FILL
TOTAL AMOUNT DUE
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 agre to comply with city and state laws regu.
ATTENTION
APPLICATION APPROVAL
lating construcllon; and In doing the work authorized thereby, no person
will be employed In Violation of the Labor Code of the Stale of Washington
THIS PERMIT
This application is not a permit until
reintIng to Workmen's Compensation Imurance.
AUTHORIZES
Signed by the Building OPPtelal or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
Uty; and Pees are paid, and receipt is Be
----
,— — —
.hall be completed In ninety days; MOVED -1N BUILDINGS shall be con-
knowledged in space provided.
Pleted In Six month',)
SIGNATURE (OWN OR AGENT)
DATE IGNEU
INSPECTION
'S SIGNATU
DEPARTMENT
gD ATE
•
CITY OF
E611IOND8
NOTE: Applicant Subject to Plan Check Fee
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775-2525
This Permit cncere work to be done an vrivate property ONLY.
Any const Ntrtkul nn the public omnia (curbs, 'Idew.lk., driveway.,
FILE
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