20020233.pdfPERMIT EXPIRES4zilla-3-
PERMIT
CITY OF EDMONDS NUMBER,-2M--0Z53-
0' SUITE/APT#
CONSTRUCTION PERMIT APPLICATION 'ADDRESS
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NUMBER
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REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RED'
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MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
GRAOINGIRLL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS AROUSES, ETCJ WILL REQUIRE
3
SEPARATE PERWISSION.
STATE SURCHARGE
PE MIT APPLICATIOM ISO DAYS
PERMIT LIMIT. I YEAR � PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG, REVIEW FEES
SEE SACK OF PINK PERMIT FDA MORE INFORMATION
*APPLICANT. ON BEHALF Or HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG, INSPECTION FEE
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY F
AND C 'ING
2 EDMONDS� WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
A'LCI-AIMS FOR DAMAGESOF WHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY
ILINEIECTA10. FEE
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT,SHALL NOT
PLAN CHECK DEPOSIT
COE
DEEMED TO MODWY� WAIVE OR REDUCE ANY REQUIREMENT OF ANY C TY ORDINAN E
N OR LIMIT IN ANYWAY THE CITY�S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
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1 TOTAL AMOUNT DUE
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS AINUCATION; I.. THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
Th 1. - . P-', ."I
THE OWNE I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
PERSON WILL BE EMPLOYED
CALL
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TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO
OF THE BE 0 THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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IN VIOLATION
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771 -0221
A FINA INS CTION A AIDE AND APPROVAL OR A CERTIFI-
I 'S EEN
ORIGINAL - FILE YELLOW INSPECTOR
CATE OF CUPANCY HAS BEEN GRANTED, UBC SECTION 109
OF
FAX
PINK - OWNER GOLD ASSESSOR
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