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BE DONE ON PRIVATE PROPERTY ONLY, AN CONSTRUCTION ON THE PUBLIC
DOMAIN EWALKS. DRIVEWAYS, MARQUEES, ETC,) WILL REOU GRADINGIFILL
(CURBS, Sin IRE
SEPARATE PERMISSION. STATE SURCHARGE
RE MITAPPLICATION: 180DAYS
PERMIT LtMIT-. I YEAR -PROVIDED ORK IS STARTED WITHIN 180DAYS ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'A PLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS ENG, INSPECTION FEE
IN INTE EST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARI&ESS THE CITY OF a i 'i
2 EDMONDS, WASHINGTON, ITS OFFICIALS� EMPLOYEES. AND AGENTS FROM ANY AND WSPEO"C"PM
ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY 08 INDIRECTLY
FROM THE I SUANCE OF THIS PERMIT. ISSU NCE OF THIS PERMIT SHALL NOT BE RECEIPT
0 EMEDTO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDI PLAN CHECK DEPOSIT I
PROVNANCI
NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANY 0 1 ROMANCE [SION." I TOTAL AMOUNT 0 13 45—
]HERE Y ACKNOWLEDGE THAT I HAVE HEAD THIS APPLICATION: THAT THE INFORMAI ION
APPLICATION APPROVAL
GIVEN 15 CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TNI IPPli'll- 11 - a P11111 11111110-4 by th,
TtON, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOY ED CALL Bo-g Offiv., .' h"1441 y; ,,J1 F ... ... p,d-d
IN VIOLATIO OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION ptpq
WORKMEN'S COMPENSATION INSURANCE AND HOW 18.27.
NEI ATE SI NE. (425)
771-0220 F"D BY
ATTENTION EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS 13EEN MADE AND APPROVAL OR A CERTIFI- 771-0221
ORIGINAL FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN� GRANTED. USC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
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