20000356.pdfIPERMIT
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USE
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CITY OF EDMONDS ZONE
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PERMIT APPLICATION;, 180 DAIS
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OHL A , AB E F TOTAL AMOUNT DUE
PPLICATION APPROVAL
I HEREBY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION, THAT THE INFORMATION
THE DULY AUTHORIZED AGENT OF
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GIVEN IS CORRECT. AND THAT AM THE OWNER, OR
Ly WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL
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, , TO INSPECTION
L. N OF THE L BOA CODE OF THE STATE OF WASHINGTON RELATING FOR
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OFFIC NAT OAT
DATE (425)
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IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
O.IGII AL FILE YE�LOW-INSPECTOR
I NSPECTION HAS BEEN M AuE AND APPROVAL OR A CERTIFI-
PINK - OWNER GOLD - ASSESSOR
A FINAL log
HAS BEEN GRANTED. UBC SECTION FAX
CATE OF OCCUPANCY
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PERMIT EXPIRES
PERMIT �17 b
CITY OF EDMONDS
ZONE
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB
ADDRESS ?�70 7
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OWNER NAME'NAME OF BUSIN,,,
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PE RMIT APPUdATION- 180 DAYS
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END. REVIEW FEES
SEE BACK OF PINK PER91T FOR MORE INFORMATION
I
ENG. INSPECTION FEE
ON BEHALFOF HIS 09 HER SPOUSE, HEISS. ASSIGNS AND SUCCESORS
;APPLICANT,
N INTEREST, AGREES TO NIFY, DEFEND AND HOLD HARMLESS THE CITY OF
:NDEM
ANY AND
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M 1) S
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w - R DAMAGES ATPER NATUR E
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INSPECTION FEE RECEIPT
DEPOSI 31-3 1--
x FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE
DEEMED TO MODIFY. WAIVE OR REDUCEANY REQUIREMENT OF ANY CITYORDINANC
PLAN CHECK
0;
,0
N iUTYTO ENFORCE ANYORDINANCE PROVISION,
OR LIMITIN ANYWAYTHE CITY'S A�l
RECEIPT
TOTAL AMOUNT DUE
I HAVE READ THIS APPLICATION; THAT THE 'NFO MATION
APPLICATION APPROVAL
I HERESY ACKNOWLEDGE THAT
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
TN. I� - . 1-11 uM'l -l"-d 1,Y -
THE OWNEW) AGREE TO COMPLY WITH CITY AND STATE LAWS REG UI-ATING CONST PLIC
CALL Eulldng OfIscial ., I,j� DI,puIy: ,d Fo.. .1. 1.1d.
TION AND DOINGTHEW RK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
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FOR INSPECTION
Co RELATING
IN VI'6U% ON OF THE LAB R DE OF THE STATE OF WASHINGTON
12AT
WORKM y� COMPENSATION INSURANCE AND ROW 18.27.
(425)
OZ&
N OR GI DA
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1 1 1 -ur-e-V RELEA5D BY
EXT 333
1� L
AtTENTION
TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
)L
I
771-0221
I T IS UNLAWFUL
HAS BEEN MADE AND APPROVAL OR A CERT(Fl,
ORIGINAL -FILE - Yll ILLOW NSPECTOR
A FINAL INSPECTION
GRANTED. UBC SECTION 109
PINK -OWNER - GOLD -ASSESSOR
FAX
CATE OF OCCUPANCY HAS BEEN