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CITY OF EDMONDS
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IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE MF R.ATION
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PERMIT APPLICATIOW, 18D DAYS
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PLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS� A SSIGNS AND SUCCESORS
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AND
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
INSPECTION FEE
RECEIPT
x FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
DEEMED TO MODIFY. WAIVE OR REDUCE ANY RE.UIREMENT OF ANY CITY ORDINANCE
ANY ORDINANCE PROVISION.
RE E EL
NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I iUWE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION PPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
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T E OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
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2 T PEON
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FOR INSPECTION
I N VIOLATION OF THE LABOR CODE
WORKMEN'S COM PENSATION INSURANCE AND RCW 18.27�
/6 ITE DATE
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7s—,74/
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771-0220
RILEASFDBY
EXT 333
ATTENTION
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771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
ORIGINAL -FILE YELLOW INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER GOLD -ASSESSOR