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FEE Description FEE
Plan Check
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City Surcharge
PLAN CHECK NO: BTED DATE
Plumbing
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: HE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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t: SEPARATE PERMISSION.
PERMrrAPPUCATION: IN DAYS
Engr. Review
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESOSS
Fire Review
Plan Chk. Deposit
IN INTEREST. AGREES 70 INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, AIRINGTON, ITS OFFICIALS, EMPLOYEES. -0 AGENTS FROM A. AND
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ALL CLAMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISS ANCE OF THIS PERMIT SHALL NOT E
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Total Amt. Due 76,
I DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF My CITY ORDINANOCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY
x ORDINANCE PROVISION.-
Recording Fee
Receipt #
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 11
THE OWNS R 'AGRE To COM Y WITH CITY AND STATE LAWS REGULATING CONSTRUC.
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Please make payable to the address listed below.
V If there are any questions, please call Candice at (206) 378-6632 or 1-800-398-4663
ex. 6632. Thank you.
Washington Energy Services
Attention Candice Gallagher
2800 Thomdyke Ave W
Seattle, WA 98199