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771-0220
RELEASED BY D
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ENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE . YELLOW INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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PERMIT
CITY OF EDMONDS ZONE NUMBER 9-061777"
CONSTRUCTION PERMIT APPLICATION 308 SUITEIAPT#
ADDRESS
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OWNER NAMEIN-1 09 BUSINESS
PLAT NAMEISUBDIVISION N I NO,
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REMARKS
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MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUES% ETC,) WILL REOUIRE
GRADING"'LL
6-10
SEPARATE PERMISSION.
STATE SURCHARGE
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RMITAPPLICATI N: 180DAYS
RE 0
RK IS STA TED
PERMIT LIMIT I YEA ' WITHIN 180 DAYS
A PROVIDEDWO
ENGF REVIEW FEES
SEC BACK OF PINK PERMIT FOR MORE INFORMATION
- —
;APPUCANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS� ASSIGNS AND SUCCESORS
AND HOLD HARMLESS THE CITY OF
ENO INSPECTION FEE
N NTESeST, AGREES TO INDEMN FY, DEFEND
I ANYAND
ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM
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EDMONDS, WASHINGTON,
ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
CITY ORDINANCE
P AN #CK DEPOSIT
0, DEEMED TOMODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY
THE CITY'S ABILITY TO ENFORCE ANY OHulin— 11-1-1-1,
ACCEIP
0 NOR LIMIT IN ANYWAY
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
OF
C_ f Z4 C I APPLICATION APPROVAL
GIVEN CORSECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT
IS
LAWS R EGULATING CONSTRUC-
T ppji,in- is not, pon'st ninits,gii—IIII.
THEOWNER* AGREE TO COMPLY WITH CIT AND STATE
I Y YED
NO PERSON WILL BE BAIR
CALL B.itn'tRit
Pit Ojn�jsj A, nint'n., G P.1y. nd P— sto tsd no
TION, AND IN DOING THE WORK AUTHORIZED THEREBY,
OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION n,.ptjs.nkn..l.d9
IN VIOLATIO
IORKIeN'SNCOMPENSATION INSURANCE AND RCW 18,27.
OF IALS SIGNATURE DATE
SIGNATURE (OWNER OR AGENT 'E SIGNED
(425)
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771-0220 RELEASED By OAT
ATTENTION 19,
EXT 333
ITISUNL FULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
AW 771-0221 —.NDHAL.IILE
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-YELL.W-INEPECT.F
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK. OWNER GOLD - ASSESSO