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THIS PERMIT AUTHORIZER O-L1 THE WORK NOT.. THIS IE..rr C.Nf... WORK To
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 D OMAIM (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
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Engr. Review
PE MITAPPLICATION: ISTDAYS
PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN IS. DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS on HER SPOUSE, HEIR% AssION. AND sU.CES..S
Fire Review
PlanClik.Deposl
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N INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS MOM ANY AND
Fire Inspection
Receipt 0
1 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
FROM THE tSSUA CE OF THIS PERMIT. SSUANCi OF THIS PERMIT SHALL NOT DE
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Total Amt. Due 155
9 DEEMED To MODI�, WAIVE OR REDU E ANY REQUIREMENT Of ANY CITY ORDINANCE
Landscape
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANN ....... -
Recording Fee
Receipt Is
I I HEREBY ACKNOWLE BE THAT I HAVE READ THIS APPLICATION; THAT THE INFOPMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
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IN LAT T E SOR CODE OF THE STATE OF WASHINGTON RELATING TO
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IT I UNLA F L To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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ORIGINAL-FILF YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. LEG SECTION 109
PINK -OWNER GOLD -ASSESSOR
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