20000237.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
MAILING ADDRESS 'r
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ADDRESS -?761-7
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REMARKS
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VESTED DATE
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTEM THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUULC
GRADINGOFILL
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DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL R 0 IRE
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 10 DAYS
PERMIT LIMI I". I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEEBACK OF PINK PERMIT FOR MORE INFORMATION
;AP Ll A T. N B 'N
EMNIFY.DEFEN AAR ESS T E ITY F
ENG, INSPECTION FEE
I TERES , EEST I
T N. I FFICIALS, EMPL YEES, A E T F ARYAND
E S IN
iF A ES F Al EVER NATURE, ISIN I E TLY R I DI E TLY
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PLAN CHECK DEPOSIT
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EE E T DIFY. AIVE REDUCEANYRE Ul E E T I NY TY R INA
N RLI ITINANY THECITY'SABIUTYTOIENF R EANY
TOTALAMOUNTDUF
THAT I HAVE READ THIS APPLICATION: THAT THE INF RMATION
TION APPROVAL
I HEREBY ACKNOWLEDGE
iE DULY AUTHORIZED AGENT OF
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IS PRE I AND THAT I A THE OWNER, OT
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RE DATE
A 'ATI S N INSURANCE AND PC 'S.27.
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(425)
771-0220
RE EASE BY
EXT 333
NTION
OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
IT IS UNLAWFULTO USE
APPROVAL OR A CERTIFI-
ORIGINAL - PILE . YELLOW - INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND
GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
CATE OF OCCUPANCY HAS BEEN
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RECEIVED
13- 6,
2q 4 60 CAN:
OCT 0 11999
61 coli W-1,
DEVELOPMENT SERVICES CTR-
CITY OF EDMONDS
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APPROVED BY PLANNiNG
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