20020664.pdf7 PERMITEXPIRES
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Description
FEE Description FEE
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Plan Check
State Surcharge
URPE
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B going Permit
City Surcharge
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ESTED DATE
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Plumbing
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
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BE DOME ON PRIVATE PROPERTY ONLY. AM CONSTRUCTION ON THE PUBLIC
ONAIN (CURBS, SIDEWALKS.DRIVEWAYS MAR OUEES, ETC.) WILL REQUIRE
SCPARATEPERM;SsION.
Grading
Engr. Review
PERMIT APPLICATION: INDAYS
PERMIT UMIX I YEAR - PROVIDED WORK 1. STUITED WITHIN Irre DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*AIPLIC . ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Review
7n C17D ... B
IN INTEREST, AGREES TO INDEMNIFY, 0 EFEND AND HOLD HARMLESS OF
THE CITY
2 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF NIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
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DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
IN OR LIMIT IN AM WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
Total Amt. DUE
_
Recording Fee
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICA7
By 1011; THAT THE INIORMATI.N
GIVEN is CORRECT AND THAT I AM THE OWNER, OR THE OULY AUTHOR ZED AGENT OF
APPLICATION APPROVAL
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAW REGULATING CONSTRUC-
TION;
CALL
This applieshon is net I perlift until signed by the
AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION 01 THE LABOR CODE OF THE STATE
Bull ding Ole W., hhher D.,u,,:..d Fee— p.1d..rd
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OF WASHINGTON RELATING TO
WORKMENS COMPENSATION INSURANCE AND SCIN UL27.
FORINSPEC TION
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KINAT E ER AGE DATE SIGNED
(4-25)
IGNAT IT DATE
all, UbAWRAR.94,11
771-0220
W,
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R E ED Y f6ATE,i
ION
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1 LAWFUL TO US�OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FI AL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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