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CITY OF EDMONDS
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PERMITAPPLICATI N: 1110DAYS
PERMIT LIMITI YEA - PROVIDED WORK 15 STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ND SUCC"ORS
PPLICANT. ON BEHALF F HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
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LEIS THE CITY OF
NDEMNIFY. DEFEND AND HOLD HARMLESS
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I HEREB ACKNOWLEDGE THAT I HAVE HEAD THIS APPLICATION: THAT IRE INFORMATION
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THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSIR G
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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APPLICATION APPROVAL
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CALL Sulldl�l 011F 1.1 .1 Dop.ty: Ild F111 11, d.
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FOR INSPECTION
OFFICIALS SIGNATURE DATE
C L
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ATTENTIONC-,4—�
(425)
0
71-0220
7 1 0
EXT 333
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IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSP ECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
771-0221
FAX
ORIGINAL 'ILE YELLOW INSPE�TOII
PINK -OWNER GOLD ASSESSOR
S198