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CITY OF EDMONDS SURFJAPT*
CONSTRUCTION PERMIT APPLICATION 'A'DOPESS A, r--
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t e LID FEE S
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ION APPROVAL
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIGN; THAT THE INFORMATION
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2 Go"M (Cu"s SIMWALM D,,,,AM NMRQUEES. ETC.) WILL REQUIRE
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PERIATTAPPLICAnON:
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SM BACK Of PINK PERMIT FOR MORE INFORMATION
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Traffic Mitigation
Plan Chk Deposit
INTEREST AGREES TO INDEMNIFY. DEFEND AND HOW HARMLESS THE CRY OF
EDMONDS, WASHINGTON. TTS OFFICALS, EMPLOYEES, AND AGENTS FROM AJI AND
Fire Review
Receipt #
ALL , I III IF WHATIVIER, 11. 11"111111 OR INDIRECTLY
FROM ME ISSUANC OF THIS PERMT1. SSU&NCE OF THIS PERMIT SHALL NOT BE
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Total Amount Due
DEEMED To MOD". WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LMUT IN ANY WAY THE CTTYB ABILITY To ENFORCE ANY ORDINANCE PROVISION!
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Receipt #
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT T1112 INFORMJ�n N
APPILICAMN APPROVAL
Gr.TN IS COFnCr. AND THAT I AM THE OWNER. OR THE DULY AUTHOIeZE AGENT OF
THE OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSI
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FOR INSPECTION
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771 -0220
RE7LEASEO 'DATE'
ATTENTION
EXT 1333
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-
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