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Description
FEE Description FEE_
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Plan Check
state Surcharge
HEAT SOURCE GLAZING % LOT SLOPE
Building Permit
City Surcharge
PLAN CHECK
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THIS PERMIT AUTHORIZES ONLY THE ORK NOTED. THIS PERMIT COVERS WORK TO
t B DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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DOMAIN (CUR111% SIDEWALKS, DRIVEWAYS a WILL REQUIRE
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SEPARATE RE RMi !MRONDEES'
Engr� Review
RE MIT APPLICATION; 180 DAYS
PERMIT LIMIT. I YEAR . PROVIDE WORK IS STARTED WITHIN 180 DAYS
Engr, Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
PLICANT, ON BEHALF F HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
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N INTEREST, AGREES TO INDEMMI11, DEFEND AND 110111 HARMLESS RIE CITY 'IF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUA CE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT 8
0 EMED TO MODIFY. WAIVE OR REDU E ANY REQUIREMENT OF ANY CITY ORDIN-C
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Total Amt, Due
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION..
RecordingFee
Receipt #
I HEREBY ACKNOWLED E THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
AP
APP ICATION FROM
GIVE IS CORRECT. AND THAI I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
T E OWNER. I AGRSE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
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TION; AND IN DOING THE WORK AUTHORIZED THERE&. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF OR-G BE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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771-0220
DATE
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI,
ORIGINAL FILE YELLOW INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 1 09
PINK OWNER GOLD -ASSESSOR
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