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THIS PERMIT AUTHORIZES ONLYTHE WORK NOTED. THIS PERMIT COVERS WORK TO
I: BE DONE ON PRIVATE PROPERTY ONV4 ANY CONSTRUCTION ON THE PUBLIC
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PERMITAPPLICATI N: IN DAYS
PERMIT LUMM, I YEAH - PROVIDW WORK IS STARTED WITHIN IN DAYS
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State Surcharge
SEA BACK (IF PINK PERMIT MR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
WASHINGTON. ITS OFFICALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Recelpt III
EDMONDS,
ALL CLAIMS FOR DAMAGES OPWKATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE IIIIIANCE 011 IS PERMD. ISSUANCE OF THIS PERMIT SHALL NOT BE
Fire Inspection
Total Amount Due
DEEMED TO MODIFY, WAIVE A REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY E ITYS ABILffYTO ENFORCE ANY ORDINANCE PROVISION..
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Receipt #
I HEREBY ACINOWL GEIN HAVE EAD THIS APPLICATION: THAT THE INFORMATION
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APPLICATION APPROVAL
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THE OWN,% I T.OWCOMPLY WITH CITY AND STATE LAWS REGULATING ONSTRUC�
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BUREE
T'." AN., . IN IN RK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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IN VIOLATION OF THE LABOR CODE OF THE
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771 -0220
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AMiNTION
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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,
ORIGINAL - FILE - YELLOW , INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
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