20000746.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNERNAMEMA
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I FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
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IROVISION."
SASIUTYTO NFORCE ANY ORDINANCE
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TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS App,,CEAToNy,. THAT THE
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771-0220
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ATTENT/ON
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771-0221
—YILI.W
—ORIGINAL
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION JOB SUITSIAPT#
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
B DONE
E 0:4 PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
SMIT APPLICATION: 180 DAYS
PE
PERMIT LIMIT: 1 YEAR, PROVIDED WORK IS STARTED WITHIN HID DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
;APPLICANT. ON BEHA F HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
N TESEST. AGREES TO �NDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
T. OFFICIALS, EMPLOYEES. AND AGENTS IS.- MYANC
I EDMONDS�WASHIAN.GTAON
- 'LCLA'. FOR. .6 OF WHATEIE�,NATUFE, ARISING DIRECTLY 08 INDIRECTLY
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x FROM THE ISSUANCE OF THIS PERMIT, SSUANCE OF THIS PERMIT SHALL NOT BE
5 DEEMED TO MODIFY, WAIVE OR REDUCE A Y RGOUIREMENT OF ANY CITY ORDINANCE -
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT' AND THAT I AM THE OWNER. THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
TION: AND IN DOING THE WORK HO I D THEREBY. NO PERSON WILL BE EMPLOYED
pAOF THE LABOR DE F THE STATE OF WASHINGTON RELATING TO
OMPENSATION I RA EANORCWIS.27.
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TOTAL-OUNT DUE
c_ 5 1-2- ol APPLICATION A 10 AL
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PF ;;�L$,StGNATURE - DATE
(425) '4' /
771-0220 RELEASED By DA E
MAI 0,2,1
A17E IT/ON
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 YELLOW - INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINA FILE
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 PAX PINK OWNER GOLD - ASSESSOR
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c_ 5 1-2- ol APPLICATION A 10 AL
Su"
CALL d, 1111 hi-lh" D0I` .. .. P., .�II
FOR INSPECTION — "_pI I, ',kg.d �p_ P_d
PF ;;�L$,StGNATURE - DATE
(425) '4' /
771-0220 RELEASED By DA E
MAI 0,2,1
A17E IT/ON
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 YELLOW - INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINA FILE
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 PAX PINK OWNER GOLD - ASSESSOR
SKIS
MAI 0,2,1
A17E IT/ON
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 YELLOW - INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINA FILE
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 PAX PINK OWNER GOLD - ASSESSOR
SKIS