20000163.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PE RMIT APPLICATION: 180DAYS
A. PERMIT LIMIT. I YEAR, PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
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TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP'UCATI.OLN� TIUIAT THE �`D
T HE W, E OR HE. A TH.11Z A.ENTOF
GIVEN IS CORRECT AND THATPLY.
To 0. WIT.MTYAN TATElWSAEDUllmoC.BSTAUC,
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CALL
THEO,N..,A.HE
TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
RELATING TO
FOR INSPECTI,
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
WORKMEN'S COMPENSATION INSURANCE AND RCW 18,27. —
I WNER OR AGENT) DATE SIGNED
(425)
771-0220
EXT333
ATTENTION
TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL
771-0221
IT IS UNLAWFUL
HAS BEEN MADE AND APPROVAL OR A CERTIFI-
A FINAL INSPECTION
HAS BEEN GRANTED, UBC SECTION 109
FAX
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