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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PERMITUMMIYEAM PROVI ED WORK IS STARTED WITHIN INDAYS Engr. Inspection
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
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Plan Chk Deposit
IN JUTE EST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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NOR LIMIT IN ANY WAY THE COTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
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Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
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APPLICATION APPROVAL
GIVEN 18 CORRECT; AND THAT AM THE OWNER OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
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TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLAT ON 01 THE LABOR CODE OF THE STATE 01 WASHINGTON RELAT'N. TO
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771-0221
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ORIGINAL -FILE YELLOW. INSPECTOR
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