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PERMIT APPLICATION: 160 DAYS
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ENG, INSPECTION FEE
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I HERED ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INF RMATION
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WORKMEN S COMPENSATION INSURANCE AND ACW 18,27,
DATE
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REMARKS
PROGRESS INSPECTIONS PER USC 1081FINAL INSPEC ON REWE
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t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRODINGWILL
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OMAIN (CURDS. SIDEWALKS. DRIVEWAYS. MARQUEES, ETC.) WILL REG IRE —
SEPARATE PERMISSION,
PER IT APPLICATIONt 180 DAYS
PERMIT LIMIM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
g'A PLICANT. ON BEHAL F HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS END. INSPECTION FEE
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING
2 EDMONDS. WASHINGTON. ITSOFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND INSPECTION FEE
LECLAWS FOR DAMAGESOFWRATEVER NATURE.ARISING DIRECTLYOR INDIRECTLY
A RECEIPT
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
DEEMEDTO MODIFYWAIVEOR REDUCEANY REQUIREMENTOFANYCITY011DINANCE
ANY WAYTHE CIrY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
0 NOR LIMIT IN
iHEREBY ACKNOWLEDGE THAT I HAVE READ THISAPPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I W THE OWNER. OR THE DULY AUTHORIZED AGENT OF CAL T
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THE OWNER. I ACRE TO COMPLY NTH CITY AND STATE LAWS REGULATING CONSTRUC- L Sild,nhg Off,cw or his/her Deputy: d Fees — pesid. d
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TION;AND DOINGTH - WORK AUTHORIZED THEREBY, NO PERSON WILL BE PLOYED
IN
t IN VIOLATION OF THE F R CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION recirpt Is ack—Isocod in m p—ded.
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WORKMEWS COMPENSATION INSURANCE AND RCW 1827. FRO SIGN UR D E
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SIGNATURE IOWNEROrAQE ,I" GAT (496y
771-0220
RELEASED BY DATEf
XKENTION EXT 1333
ITIS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURELINTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL� FILE
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
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