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'APPLICANT, ON BEHALF 0 HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
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GNP PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC GRADINGFILL
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DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION. STATE SURCHARGE
MIT APPLICATION: 160 DAYS
PERMIT LIMIM 1 YEAPR � PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES
SEE. BACK OF PINK PERMIT FOR MORE INFORMATION
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'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIR% ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY� DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING
2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPILOYEES� AND AGENTS FROM ANY AND IN PECTtON FEE
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FROM T.BBBUANCE 0, THIS PERMIT. ISSUANCE OF THIS P 'BE FLA. CHECK DEPOSIT
DEEMEOTO MODIFY, WAIVE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINAN �E
CITY'SABILITY TO ENFORCE ANYORDINANCE PROVISION. RECEIPT
6vo
0 NOR LIMIT IN ANY WAYTHE
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT., A D THAT I AM THE OWNER . OR THE DULY AUTHORIZED AGENT OF nd.rorani ay'a.
N S REGULATING CONSTRUC-F60S are plrd. ad
STATE LAW 'CALL
THE OWNER. I AGREE To COMPLY WITH CITY AND ia ng oputy: and
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED aPiard
OF THE LA CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION JaIII,drarratirdi; dia.pid, panadd.
IN ViOLATIO
KMEN'S COMPENSAT NSURANCE AND PCW 18.27. 0 IALS SIGNATURE
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SIGNED
NATU E AGEN,T� (425) 171
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771-0220 RELEA EDBY
EXT1333 oi�)
ENTIOIq
IT IS UNLAWFULTOUSE 08 OCCUPY ABUILDING OR STRUCTURE UNTIL 771-0221 YELL INSPECTO
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE
COIL -ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER