20020315.pdf'] DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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NUMBER
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PLAT NAMEISUBDWISION NO. LOT NO. LID NO.
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REMARKS
OWNER,CONTIAI
OWNERICONTRACTOR RESPONS15LE FOR EROSION CONTROUDRAMAGE
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THIS PERMIT AUTHO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN ICURSS, SIDEWALKS, DRIVEWAYS . MARQUEES, ETC.) WILL REQUIRE
GPFCIRGP`ILL
SEPARATE PERMISSION.
SURCHARGE
PE MIT APPLICATION: 180 DAYS
PERMIT LIMIT, I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
END INSPECTION PEE
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N NTEREST. AGREES TO INDEMNIFY, DEFE14D AND HOLD HARMLESS THE CITY OF
M EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY
LANDSCAPIN
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RECEIPT
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PLAN CHECK DEPOSIT
0 NOR LIMIT IN ANYWAY THE CH Y'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
TOTAL A. UNT DUE
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IHERES ACKNOWLEDGE THAT I HAVE READ THISAPPLICATION� THAI THE INFORMATION
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ICATION APPROVAL
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TION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL 81 EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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