20020784.pdf'DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEMAME OF BUSINESS
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PROPERTY TAX ACCO NT PARC
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PROGRESS INSPECTIONS PER DEC 108/11FINAL INSPECTION RECrD
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Grading
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DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
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SEPARATE PERMISSION.
a PE MIT APPLICATION-. IN DAYS
Engr. ReVieYt
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H N I a a OA Y S
PERMIT LIMIT I YEAR - PROVID 0 WORK 15 STARTED WITHIN led DAYS
Engr. Inspection
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SEE BACK OF PINK PERMTT FOR MORE 1.1.11MAT1.11
AT ON
IPPUCA1 01 REIF 11 "IS 11 "Ell SPOUSE, "E"'F ASSIGNS AND SUCCEsOTffi
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Plan Chic. Deposit
ARMLESS THE IT' OF
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AN. HOLD HARMLESS THE CITY OF
GENT. MGM ANY AND
EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYE S. AND AGENTS MOM ANY AND
K`E-TTY OR INDIRECTLY
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
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Receipt N
FE..,T SNA" NOT BE
FROM THE ISSUANC OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
F Y I- ORDINANCE
DEEMEDTOMODI WAIVE OR REDUCE ANY REQUIREMENT OF My CITY ORDINANCE
JCONS�UC
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Total Amt. Due
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE '..�rsON -
Recording Fee
Receipt #
HA MA
I HERE 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
OWNER. I BEE TO COMPLY WITH CITY AND STAT LAWS REGULATING
THE LA
CALL
Thia I la all a P.Irah.dfil �llffiiid by fla
N; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
TIO .0. WrL a MP_YE
LA
N VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
B,Ildl,g Official a, hisih,r Dopi,iy: and F 81, paid, and 11
FOR INSPECTION . ,Ipt 1, ack—Ildeed In $poll Inclined,
WORKMENS CQ_MPENSATION 11 SURANCE AND RCVV 18.27.
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ATTENTION
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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-
I/ ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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