750261.pdfUSE PERMIT
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BUILDING DEPARTMENT Applicant FBI
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PERMIT APPLICATION Inside Heavy Lines
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DEMOLITION
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EXCAVATION OR FILL
TOTAL AMOUNT DUE
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I hereby acknowledge that I have read this appllcnlion; lhnt lha In•
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formation given le Correct; and that I a a the owner, or the duly author-
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ATTENTION
APPLICATION APPROVAL
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laling construction; and In doing the work authorized thereby, no person
a•Ill be employed In vlolatlan o1 the Labor Code of the Slate of Wnshington
THIS PERMIT
This application is not a permit until
relating to Workmen's Corepecoation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
ut and Pees are aid, and receipt i9 6C -
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Ill.) be completed In ninety day.; MOVED -IN BUILDINGS shall be cons-
owledged in apace provided.
Pleted In six months.)
SIGN TUBE (OWNER OR AGENT) DATE SIONEU
INSPECTION
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DEPARTMENT
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CITY or
EDMOND$A�--_--""'--
NOTE: Applicant Subject to Plan Check Fee
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775-2525
Tide Pemut Nlrere work to be done on private property ONLY.
Any construction on the pumle dunraln (curbs, sidewalks, drlvew y.,
o—quee., etc.I will req m eeplural. pennisdon,
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Legal DesCrlptlon of Property (Show Below
or Attach Four Copies)
REMARKS
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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RESIDENTIAL
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PLAN CHECKED DY THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIALSIGN
/// OF EDMONDS, LOCAL SALES TAX
ADD
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NUMBER OF BTOIt1EH NUMBER OF
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NATURE OF FORK TO BE DONE
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Receipt No.
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BUILDING
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PROPOSED UBE \
PLUMBING
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PLAN (IndlC¢l. BulI{gg�aptbael(p RZE Ing street.)
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DEMOLITION
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PRE -MOVE INSPECTION
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EXCAVATION OR FILL
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I hereby acknowledge that I he- rend this application; that the In.
TOTAL AMOUNT DUE
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formntlon given la correct; and that I am the owner, or the duly author-
lred agent of the owner. I agree to comply with city and state laws regu•
ATTENTION
APPLICATION APPROVAL
1
,.ting construction; and In doing the work authorleed 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
'
relating to Workmen's Compensation Imurance.
AUTHORIZES
Signed by the Building Official or his Dep-
!
IL
NOTE: Permit Limit One Year (Exeept DEMOLITIONS which
ONLY THE
and fees are aid, and receipt Is ac -
.hall be c In maety deye; MOVED -IN -IN BUILDINGS shall be Conn.
Isnowledged in space provided.
.
plcled In sIX ix mont m¢ntha.)
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SIGNATURE (OWNER OR AGENT) DATE SIGNED
/ �f �" • �•
INSPECTION
DEPARTMENT
1 DIRECTO 8 SIO ATUFIE ) I
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CITY OF
NOTE: Applicant Subject to Plan Check Fee
EonfoNDB
DATE �j
775-2525
This Per It eorere work to be done on prlr.te property ONLY.
Any construction on the public domain (Curb., sidewalk., driveways,
marquees, etc.) will require separate permleslon.
- INSPECTOR