20000889.pdfCITY OF EDMONDS
LEE PERMIT
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THIS PERMIT AUTHORIZES ONLY THE IN..K NOTED. THIS PERMIT COVERS WORK TO
It: SEDONEON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC GRADING/FiLL
DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS . MARQUEES, ETC.) WILL REOUI
SEPARATE PERMISSION.
ACHARGE
PERMIT APPLICATI N: 180 DAYS
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PERMIT LIMIT I YEAR - ROVIDED WORK IS STARTED WITHIN 180 DAYS ENE. REVIEW FEES
SEE BACK OF PINK PERMIT FOR NOSE INFORMATION
ENG. INSPECTION FEE
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, 111111, ASSIGNS AND IUCCEIORS
IN IIlTllEST=.ETSoTO INDEMNIFY' DEFEND AN. OLD HARMLESS THE CITY OF LANDSCAPING
EDMO W N� IT. OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND I.lElTI.NlEE
ALLOL,mms FOR DAMAGESOF WHATEVER NATURE , ARISING DIRECTLY OR INDIRECTLY RECEIPT
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT $HALL NOT BE PLAN CHECK DEPOSIT
DEe'ED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANC
NOR LIMITINANY WAY �Z CITY S ABILITY TO ENFORCE ANY ORDINANCE PROWSION�' R StPT
_ TOTAL AMOUNT DUE 0
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION� THAT THE INFORMATION APPLICATION APPROVAL
GIVEN ARECT, AND T AT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF � w- I,
IS CC I AGREE To COMPLY WITH CITY A CALL D., I, d F. � I . 1.
THEOWNgR NO STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
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;Ig. DE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
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�GNATURE
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ATTENTION EXT/333 ----------------------
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 '
A FINAL NSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ONGINAL-FILE YELLOVV- INSPECTOR
CATE OFIOCCUPANCY HAS BEEN GRANTED, USC SECTION 109 FAX PINK OWNER GOLD -ASSESSOR
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PE MITAPPLICATION: 180 DAYS
PE-M�
PERMIT UMIT.. 1 YEAR - PROVIDED WO K IS STARTED WITHIN 180 DAYS
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ENG. REVIEW FEES
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SEE BACK Oi PINK PERMIT FROR MORE INFORMATION
OF
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'APPLICANT ON IIIIALF OF 1111 OR 11 . E .. R . 11OUS1, HIIIIS, ASSIGNS AND SUCCESOAS
F L OF H
ENG. INSPECTION FEE
IN INTEREST. AGRESS TO;NDVNI�, DEFEND AND HOLD HARMLESS THE CITY F
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2 EDMONDS. WASHINGTON, TS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
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INSPECTION FEE
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PLAN CHECK DEPOSIT
DEEMEDTO MODIFYWAIVE OR REDUCE ANY REOUIFIEMENTOF ANYCITY ORDINANCE
NORLIMITINAN WAYTHECITY'SABILITYTO ENFORCE ANYORDINANCE P
Y W Y T. CR
.0. LIMIT IN Y
TOTAL AMOUNT DUE
RECEIPT
IHERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN RECP. A D THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
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THE OWNECAO I ABASE TNO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
CALL
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TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
THE S � .1 WAIHI GTON RELATING TO
FOR INSPECTION
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(425)
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771-0220
BY
ATTENTION
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 . FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER GOLD -ASSESSOR
S�s
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