20020736.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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ADDITION COMMERCIAL
o COMPLIANCE OR
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REPAIR [3 GRADING G,ca
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REMARKS
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NUMBER NUMIER 0 F CRITICAL OCCUPANT
OF DWELLIN AREAS LOAD
$TOR"S UNITS NUMBER
DESCRIBE WORK TO BE DONE RENA KS
f PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD
(loa neto (105, furn(v,
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FEE
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Plan Check
LOT SLOPE
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PLAN CHECK NO: VESTED DATE
Plumbing
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION 01" THE PUBLIC
Recording Fee
?1 .1 WILL RE.Uh..
DOMAIN (CURIOS. SIDEWALKS. DRIVEWAY% MARQUEES, ET
.3 SEPARATE PERMISSION.
Engr, Review
City Surcharge 15 0 01
PER ITAPPUCATIOW HODAYS
PERMIT UMM I YEAR - PROVID D WORK 15 STARTED WITHIN I so DAYS
Engr, Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-PUCANT ON BEHALF 01 HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES To INDEM"11. DEFEND AND HOLD FIA1111-116 THE CITY 01
'GMONDS - WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
-
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIREC71Y OR INDIRECTLY
FROM THE I SUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Fire Inspection
Total Amount Due
DEEMED TO MODIFY. WAIVE OR REDU E ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR L1141T IN ANY WAY THE CITrS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
#
Landscapainsp.
Receipt
THERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
CONSTRUC.
this trepanation is net a permit unfil,igned bysm,
THE OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING
AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
CALL
B,ildi,g Glacial or hedher Dopuy: and Form are paid. and
'ON;
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
scarier is ack-lodged In space pnonlarid.
WORKIMENS COMPENSY!5"NCE AND NOW 18,27.
OZAL�1�11'GN� TE
SZZTU�/ jPWNER AT NED
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RELEASED BY DATE
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL,FILE - YELLOW INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER - GOILD�ASSESSOR
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