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IHERE Y ACKNOWLEDGE THAT I HAVE AE.ADWTH;EAppTLICATUNy. THAT THE INFORMATION
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CPERMIT
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ZONE PERMIT 20011.5
CITY OF EDMONDS
NUMBER
JOB SUITEIAPT#
CONSTRUCTION PERMIT APPLICATION
ADDRESS 0L J,
OWNER Nn� O� B EBB
PLAT NAMEISUBDIVISION NO�
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SEPARATE PERMISSION.
STATE SURCHARGE
PERMITAPPLICATI Nz 180DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
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ENO -INSPECTION FEE—
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��APP.LT'C.AEN.TiOAIBI�E�H�A�'�l. CITY OF
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE
PLAN CHECK DEPOSIT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION -
TOTAL AMOUNT DUE
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT TH E INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
7- -F - -'-" .-I -'red by -
THE OWNER' I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
BE EMPLOYED
CALL
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TtON. AND IN DOING THE WORK AUTHORIZED THE RESY� NO PERSON WILL
CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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IN VIOLATION OF THE LABOR
WORKMEN'S COMPENSATION INSURANCE AND RCW 18,27,
OFFICIALS SIGNATURE DATE
- 0 N E SIGNED
(425)
771-0220
1 RELEASED fly
ATTENTION
EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
- - ----- ---
HAS BEEN MADE AND APPROVAL OR A CERTIFI_
ORIGINAL - FILE - YELLOW � INSPECTOR
A FINAL NSPECTION
CATE OFIOCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
FAX
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