20010703.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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VALUATION
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PLA N CHECK NO: IVESTED DATE .
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU
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PERMIT APPLICATIO N: 180 DAYS
PERMIT LIMIT-. I YEAR. PROVIDED W..K IS STARTED WITHIN 100 DAYS
ENG, REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
ENG INSPECTION FEE
;APPLICANT
N INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
EDMONDS, IHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS 'ROM ANY AND
WA RE. ARISING DIRECTLYOR INDIRECTLY
ALlLCl_AIMSrORDAMAGESOFWHATEVER NATU
INSPECTION FEE
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FROM THE SSUANCE OF THIS PERMIT ISS ANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
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DEEMEDTO MODIFY. WAIVEORREDU E ANY REOUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY S ABILITY TO ENFORCE AN Y ORDINANCE PROVISION.'
TOTAL AMOUNT DUE
IR CEIPT/ T
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I HEREBY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION: THU THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT A THE OWNER. OR THE DULY AUTHORIZED AGENT OF
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..FLY ITH CITY AND STATE LAWS REGULATING
THE OWNER, I AGREE TO C W
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CALL
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DOING THE WORK AUTHOR Z ED THEREBY. NO
IN VIOLATION OF THE LABOR INGTON RELATING TO
THE STATE OF WASH
FOR INSPECTION
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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FINAL APPROVAL FOR
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC
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TH 'TY '
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IN NTEREST, AGREES TO;NDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
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ALLCLAIMS FOR DAMAGESOF WHATEVER NATURE.ARISING CIFIECTLYORINDIRECTLY
INSPECTION FEE
FE—CEIPT
L T S
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FROM THE ISSUANCE OF THIS PERMIT ISSU OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
NO
DEEMEDTOMODIFY. WAIVE OR REDUCEANY REOUIREMENTOF ANY CITY ORDINANCE
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TOTALAMOUNT DUE
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APPLICATION
APPROVAL
I HEREBY ACKNOWLEDGE
GIVEN IS CORRECT AND THAT I AM tHE OWNER. OR THE DULY AUTHORIZED AGENT OF
Th,. ppi-Inn I. ..t a ienot until signehi by the
:THAT :INF :R"Tl:
THEOWNE IAGREETO COMP LY VVITH CITY AND STATE LAWS REGULATING CONSTRUC.
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WILL BE EMPLOYED
CALL
CALL
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TION;ANDSN DING THE WORK AUTHORIZED THEREBI. NO PERSON
I VIOLATIOM E To T To
N OF THE LAEOR CODEOF THE STATE OF WASHINGTON RELATING TO
0 1 Sp CTIO ipti—k—linig.din.p..P.Ykeel.
FOR INSPECTION —
WOIIEN'SUUM:!t:=rCEANt)RCWIB.27.
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DATE SIGNED
(425)
c1-19 1
771-0220
FEUEAIED.Y
EXT 1333
ATTENT16N
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
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