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CITY OF EDMONDS
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Be DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PU'.L.C.
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SEPARATE PERMISSION.
PE MIT APPLICATION: 180 DAYS
PERMIT LIMIT. I YEAR PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK O� PINK PERMIT FOR MORE INFORMATION
Tmm.—e-vrn
-APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASISAIGNS ASNSQTSHUECCESORS
IN INTEREST, AGREES TO IN 'MNFY RMLS CIT OF
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NOR LIM, E A.,
PLAN CHECK
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
MTHEOWNE OR THE DULY AUTHORIZED AGENT OF
GIVEN IS CORRECT AND THAT I A, 9' TRUC-
THE OWNER. I AGREE TO COMPLY ITH CITY AND STATE LAWS REGULATING CONS
CALL
Wih P.ty: F- .. P ll�
B�i T�� hi�..' B
TION.ANDINOOINGTHSWO K AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
OF THE LAND CODE OF THE STATE OF WASHINGTON RELATING TO
OF THE LAND
FOR INSPECTION
9�"� p,-dod�
IN VI N
DLATJO
W 'MEINS COMPENSATION INSURANCE AND POW 18.27,
OR
OFFICIALS SIGNAT DATE
SIONNT (OWNE
ED
(425)
OW—
771-0220
RELEASED By
'ENTIGN EXT 333
IT IS UNLAWFULTO 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
GOLD ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK - OWNER
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