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CONSTRUCTION PERMIT APPLICATION
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SEE BACK OF PINK PERMIT FOR M FORM I
ENG. REVIEW FEES
'A PLICANT, ON BEHALF OF HIS OR HER SPOUSE, H RS,AS GNSANDSUCCESORS
ENG, INSPECTION FEE
PI SS THE CITY OF
, IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND OLD RMIE
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEE
DSCARING
ALLCLAIMS FGR DAMAGESOF WHATEVER NATURE,ARISIII
FIT M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE
INSPECTION FEE
PLAN CHECK DE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINA
0 NOR LIMIT IN ANY WAY THE CITY*S
ABILITY TO ENFORCE ANY OR PROVISINC
ENNANCE ONE
TOTAL AMOUNT DUE
1 1117 1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I Am THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLfCATItNVPPR;Vt
THEOWNER IAGREET.�.MPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
TION. AND,IN 0 ING THE WORK AUTHORIZED
CALL
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THEREBY. NO PERSON WILL BE EMPLOYED
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IN OL T ON OF THE LABOR CODE DEE THE STATE OF WASHINGTON
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RELATING TO
WORKMEN'S COMPENSATION INSURANC AND BOW 18.27,
FOR INSPECTION
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771-0220
ATE
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI�
771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
ORIGINAL FILE . YELLOW 6NSlECfOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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