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CITY OF EDMONDS
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PERMIT APPUCATLDN: 180DAYS
PERMIT LIMIT. I YBAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
ENG, INSPECTION FEE
IN INTERESI AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
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1 HEREBY ACKNOW EWE THAT I HAVE READ THIS APPUCAT,,H� THAT THE INDORMATION
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771-0220
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IT ITUNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTI
771-0221
A FINAL IN SPECTION HAS BEEN MADE AND APPROVAL OR A CERTIF -
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PLUMBING:
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Gas Piping .................
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EXTERIOR SHEATHING
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SEPARATE PERMISSION.
STATE SURCHARGE
PER.ITAPPLICATION: 180 DAYS
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PERMIT LIMIT: I YEAR - PROVIDED WORK S STARTED WITHIN 100 DAYS
YEAR
ENG. REVIEW FEES
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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PELICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
A P
F
ENG. INSPECTION FEE
IN INTEREST. AGREES TO INDEKNI FY. DEFEND AND HOLD HAPARESS THE CITY 05
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INSPECTION FEE
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DEEMED TO MODIFY. WAIVE OR REDUCE
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OR LIMIT IN ANY WAYTHE CITY
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TOTAL AMOUNT DUE 11
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IHERE8YACKNOWLE.IT.ATI.VE READ THIS APEL�ICATION. THAT THE INFORMATION
APPLI ATION APPROVAL
GIVEN IS CORRECT. AND THAI I AV. THE OWNER. OR THE DULY AUTHORIZED AGENT 01
THEOWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
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TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
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FOR INSPECTION
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IN V TION OF III LABOR CODE 01 THE STATE
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OA
(425)
771-0220
Y DATE
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EXT 1333
FILE SED
IT I, UNLIAWF I- TO USE 08 OCCUPYA BUILDING OR STRUCTURE UNTIL
IT
771-0221
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A NAL INSPECTION AS BEEN MADE AND APPROVAL OR A CERTIFIk
ORIGINAL - Ell . LLD
AS ESSD
CATE OF OCCUPANCYHHAS BEEN GRANTED, U8C SECTION 109
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