20000944.pdfPERMIT
CITY OF EDMONDS
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PE AMITAPPLICATION: 100-AYS
W FIX IS STARTED WITHIN 180 DAYS
YEAR. PROVIDED 0
ENG. REVIEW FEES
PERMIT LIMIT, I
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
AND HOLD EBB THE CITY OF
ENO. INSPECTION FEE
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INDEMNIFY, DEFEND
IN INTEREST AGREES TO F AL - TSFROM ANYAND
EMPLOYEES ANO=L
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2 EDMONDS. WASHINGTON ARISING
=� ALLCtLAIMS FOR DAMAGE�ITFWFAITCEIVEE NATURE. DIRECTLY OR INDIRECTLY
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x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NO
ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
DEEMEOTOMOOt Y, AIVEO REDUCEANY REOUIREMENT OF
'SABIUTY E ORDINANCE PROVISION.
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NORLI TINANY AYTHEClTY'SABIUT NFOACEANY
MI
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT: AND THAT I AM EgNER RATH, GULYAUTHORjlEO AGENT OF
60 E LA E.ULATING CONSTRUC
CALL
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TION; AND IN DOING T TE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
TO
OR INSPECTION
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IN VIOLATION OF THEN LABOR CODE OF THE STATE OF WASHINGTON RELATING
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WORKMEN'S COMPENSATION INSURANCE AND RCW le .27�
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IT IS UNLAWFULTO USE OR OCCUPYAWILDING OR STRUCTURE UN TIL
771-0221
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL
- GOLD -ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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