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;APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEI.S. ASSIGNS AND SUCCESORS
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IF
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TOTAL AMOUNT DUE
RECEIPT
RECE IPT
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
IN LDEEMED
GIVEN ty CO RECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
. S Ri AGREE To COMPLY WITH CITY AMD STATE LAW
THE OWNER. S REGULATING CONSTRUC
TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON Will BE EMILCIED
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WORKMEN S COMPENSATION INSURANCE AND RCW 1 B.27�
10 ATUREjoy; 4 GENT) D E SIGNED
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APPLICATION APPROVAL
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771-0220 SEDBY
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
MADE AND APPROVAL OR A CEPITIFI-
ORIGINAL -FILE - YELLOW - INSPECTOR
A FINAL INSPECTION HAS BEEN
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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GONZALES DESIGN PARTNERS
P.O. BOX 97, 6823 211 TH PLACE NE
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ARLINGTON, WASHINGTON 98223
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October 15,1999
To: Ms. Meg Gruwell, Planner
City of Edmonds
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121 - 5 th Avenue North
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Edmonds, Washington 98020
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RE. Dr. & Mrs. Stolzenburg Residential Addition
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7003 - 156 th Street SW
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Edmonds, Washington
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Dear Ms. Gruwell,
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Please accept this letter as written authorizabon to with draw the "Request for Appeal to City
Council", for the above noted project Also please apply
the $300.00 fee paid for the appeal
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to the Residenbal Building Permit Fee.
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Thank you f or your help in processing this request.
if you have any que stions please contact
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me at 360435-5514.
Thank you, Sincerely
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Ruth E. Gonzales
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Architect
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OCT 15 1999
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
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6� 1URCHARGE
PERMIT APPLICATION: 1110 -15
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ENG. REVIEW FEES
SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION
'A PLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS A SUC ES RS
P
Ell. INSPECTION FEE
DEFEND AND HOLD HARMLE S THE CITY F
IN INTEREST. AGREES To INDEMNIFY, E
WASHINGTON, ITS OFFICIALS. MPLOYEES. AND AGENTS FROM ANY AND
LANDSCAPING
iNSPECTION FEE
2 EDMONDS.
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT $HALL NOT BE
PLAN CHECK DEPOSIT
RECEIPT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUIREMENTOF ANY CITY ORDINANCE
'
NOR LIMIT IN ANY WAYTHI CITY'l ABILITY TO ENFORCE ANY ORDNANCE PROV11101
TOTAL AMOUNT DUE
RECEIPT
IHER15Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE OULY AUTHORIZED AGENT OF
STATE LAWS REGULATING CONSTRUC-
Thm pplim.t- i� 1 . P-11 --tll�liglsd by th,
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THE OWNER. I AGREE TO COMPLY WITH CITY AND
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OF THE LABOR ODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION ipt , ,k,.Itldg.d n . P_
IN VIOLATION
WORKMEN'S COMPENSATION INCSURANCEAND RCW 16,27.
OFFICIALS S ATURE D TE
ATE SIGNED
(425)
SIG TURE (OW
z Is"T
771-0220 DATE
A
1 AIED BY
I
EXT1333
ENTION
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING 08 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
FAX PINK -OWNER GOLD ASSESSOR
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