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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
BEHALF OF HIS OR HER SPOUSE. HEI RS. ASSIGNS AND SUCC5SORS
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IN INTEREST. AGREES TO �NDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON TS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALLCLAIMSFO E, ARISING DIRECTLY OR INDIRECTLY
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THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
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DEEMEDTO MOD"YWAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
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THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING
NO PERSON WILL BE EMPLOYED
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EXTERIOR SHEATHING
NAILING ......................
FRAMING .......... .............
FIRST FLOOR FRAMING
INSULATION ..........
Floor Insulation
Wall Insulation ...........
Calling Insulation
SHEETROCK NAILING
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ENG. REVIEW FEES
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TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPTICEATION THAT THE INFORMATION
AGENT OF
CUL�
GIVEN 15 CORRECT; AND THAT I AM THE oWNER� OR AUTHORIZED
Y AN' STATE I.AWI REGULATING CONSTRUC-
CALL
E R " To Co M P LYjW".HlC . TI.E.Y. . PERSON WILL BE EMPLOYED
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T, N I ,N.T.E ORKA
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OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTII
IN VICLATtoN OF THE LABOR CODE
woRKI,lEN'S COMPENSATION INSURANCE AND RCW 18.27.
SIGNAT F`(oWNERO GENT)
CAT SIGNED
/121L)j
(425)
771-0220
EXT 333
ATTENTION
USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
i IT IS UNLAWFULTO
i BEEN MADE AND APPROVAL OR A CERTIFI-
i A FINAL INSPECTION IHAS
B EEN GRANTED. UBC SECTION 109
FAX
CATE OF OCCUPANCY HAS
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