20000117.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AppUCATJON� THAT THE INF FIMATION
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WITH CiTY AND STATE LAWS REGUI-ATING CONSTRUC -
THE OWNER, I AGREE TO COMPLY
TION: AND IN DOING THE WORK AUTHORIZED THEREBY'No PERSON WILL BE EMPLOYED
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TOTAL AMOUNT DUE
CALL
FOR INSPECTION
(425)
771-0220
A*ENTION 00.3
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
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RMITAPPLICATION: VIDDAYS
PERMIT LIMIT. I YEAPRE PROVIDED ORK IS STARTED WITHIN 150 DAYS
SEE BACK O� PINK PERMWIT FOR MORE INFORMATION
ENG. REVIEW FEES
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-APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. A SIGNS AND SUCCESORS ENG. INSPECTION FEE
N INTE EST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING
X ED R EMPLOYEES, AND AGENTS FROM ANY AND
MoNos, WASHINGTON, ITS OFFICIALS. INSPECTION FEE
FWHATEVER NATURE. ARMING DIRECTLYOR INDIRECTLY
ALLCLAIMSFORDAMAGES0 T BE
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMITFTyHALL.NO PLAN CHECK DEPOSIT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OFANY C OR .ANCE
NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' '
TOTAL AMOUNT DUE
RECEIPT
REC
I HEREBY ACKNOWLEDGE TH E READ THIS APPLICATION: THAT THE INFORMATION
AV
AT: HM THE OWNER. OR THE DULY AUTHOF STRUC
GIVEN SCOARECT AND THAT A RIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CON
TION�ANDINDGtNGTH WO K AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
OFTHELA R CODE OF THE STATE OF WASHINGTON RELATINOT.
IN VIOLATION 80 p ROW 16.27.
WORKYEN'S COMPENSATION SURANC5 AN
Sl lo�NEROZG� I/ DATE SIGN
APPLICATION APPROVAL
E.,Thl F "till" met a Palm" Ull",lign.dby In.
CALL dm Olt' I er hisihii, Dlp,,Iy: and Fees ano paid. and
FOR INSPECTION meal j...tm.w.dq.dtl.o.eye.naJ.d.
OF CI j NATURE
(425)
7 -0220 RE SEC.'
71
A*ENTION
IT IS UNLAWFULTO USE 08 OCCUPYABUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
EXT 333
771-0221
FAX
ORIGINAL - FILE
PINK -OWNER =WAB '111,1