20010883.pdfk DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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CITY OF EDMONDS
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Receipt #
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a— NOT BE
SHALL NOT BE
PERMIT
PROUTHEISSUANCEOFTHISPERMIT SSUANCE OF THIS PERMIT
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OEEMID TO MODIFY, WAX11 OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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Fire Inspection
T.tal Amount Due
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Receipt #
I HERE ACKNOWLEDGE THAT I HAV&READ THIS APPLICATION: THAT THE INFORMATION
Sy
APPLICATION
APPROVAL
GIVEN 0 CCRIRECT'. AND THAT I AWTHE OWNER. 09 THE DULY AURTHORUED AGENT OF
THE OWNEFL I AGREE TO COMM WITH CITY AND STATE tAWS REGULATI-NG CONSTRUC-
CALL
TW. apqllca� Is nat a p—It "d -lamd by M
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
0 1 NS C
FOR INSPECTION
dj Oflklel m NIjbw D,": me Fees we paid
IN vjo�TION
WORKMEWS COMPENaA4N INSURANCE AND RCW 18,27.
DATE
07
BIGHATU ER 011,!2�"
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(425)
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771-0220
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By' DATE
A7,MNTION
'T , "
E)ff 1333
FrIS 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 - YEIIAW�INSI
CATE OF OCCUPANCY RAS BEEN GRANTED. USC SECTION 109
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