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THIS PERMIT AUTHOAIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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SEPARATE PERMISSION.
PERMIT APPLICATI N: 180 DAYS
PERMIT LIMIT. I YEAR, PROVIDED WORK IS STARTED WITHIN 18D DAYS
SEE BACK OF PINK PERMIT FOR MORE INFOR ATION
A ;APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, A SIGNS AND SUCCESORS
N INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALL CI -AIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FR M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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STATE SURCHARGE
PERMIT APPLICATION: 180-AYS
PERMIT LIMIT, 1 YEAR " PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
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LICANT N ALFOF SORHERS OUS HE ASSIGNS AND SUCCESORS
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TO USE OR 1)CCU1Y A BUILDING 771-0221
IT IS UNLAWFUL
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- oRIGINAI.�'Ffl!E YELLOW INSPECTO
ASSESSOR
A FINAL
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PINK OWNER GOLD -
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