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PE RMIT APPLICATION; '80 DAYS
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ENG, REVIEW FEES
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' ALI IF HIS on HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
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TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ APPLK`ATIULY, T"AT TH"N.FORMATION
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SEPARATE PERMISSION..
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PERMIT APPLICATION: 180 DAYS
E PERMIT LIMIT'. I YEAR - PROVIDED WORK IS STARTED WITHIN 1IID DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPUCANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUGCESORS
ENG. INSPECTION FEE
IN INTEREST AGREES TO I DEMNtFY. DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
2 EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTSFROM ANYAND
ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY
INSPECTION FEE
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
ANY ORDINANCE PROVISION."
PLAN CHECK DEPOSIT
JFIE��IPT
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE
TOTAL AMOUNT DO E
EIPT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THI S APPLICATION; THAT THE lNlOHMA.Tll.N
APPLICATION
APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OW EGULATING CONSTRUC-
NER. IAGREE TO COMPLY WITH CITY AND STATE LAWS
P,,. P—it u0l..' I,,
CALL
I
TION; AND,IN DING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
ITOMTPI; —, puty:,ndF... pdd
i�
rOR
IN VIOLAT ON OF THE LABOR CODE OF TUE STATE OF WASHINGTON RELATING To
F 0 1 opI I, ,k,,.Iodgod p-d-
INSPECTION — -
I
WORKMEN'S COMPENSATION INSURANCE AND ROW 18.27.
OFFICIA ' ATE
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(425)
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1 'VC-r-V RELEASEURY
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0 N
EXT 333'
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 - PILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX PINK - OWNER - GOLD . ASSESSOR