20000144.pdfDATE RECEIVED
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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NAME
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771-0220
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El'ITION
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771-0221
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da 'APPLICANT. ON BEHALF F HIS OR HER SPOUSE, HEIRS, ASSIGNS A D SUCCESORS
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ENG. INSPECTION FEE
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TOTALAMOUN D E
THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICA11 IUN APPROVAL
I HEREBY ACKNOWLEDGE
GIVEN I CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
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PFICIA SK-ATU I E DATE
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(425)
771-0220
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ATTE ION
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELLOW INSPECTOR
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