20000451.pdfIDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PLAN CHECK PEE
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WAN CHECK NO:
IVESTED DATE
PLUMBING
THIS PERMIT AUTHO IZES ONLY THE WORK NOTEM THIS PERMIT COVERS WORK TO
MECHANICAL
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BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON T E PU IUC
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PERMIT APPUCATI N: 180 DAYS
��SUNCHARGE
PERMIT LIMIM 1 YEAR - PROVIDED WORK IS STARTED WITHIN IBO DAYS
SEE BACK OF PINK PERMIT FOS MORE INFORMATION
ENG, REVIEW FEES
P
'A PLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS� ASSIGNS AND SUCCESORS
ENG INSPECTION FEE
IN TEREST. AGREES TO INDEMNIFY.
IN DEFEND AND HOLD HAA.LESS T I CITY OF
2 EDMONDS,WA HINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FF H ANY AND
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY
LANDSCAP NG
INSPECTION FEE
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
D E
EEMED TO MODIFY, WAIVE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINANc
PLAN CHECK DEPOSIT
NoFL .. TNAY WAY THE CITY'$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS 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*
T,ON; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
I N VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
CALL
FOR INSPECTI,
WORKMEN'S COMPENSATION INSURANCE AND HOW 18ZT
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_1SIGNATUR
771-0220
-ATTENTION'
EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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