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PERMIT EXPIRES 44-
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Plan Check
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Building Permit
City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZER ONLY THE ORK NOTED. THIS PERMIT COVERS WOSKT0
B DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
a ILL REQUIRE
3 DOBARN JCURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) W
SEPARATEPERMISSION.
-
Engr, Review
PERMITAPPLICATION! He DAYS
PERMIT LIMIT. I YEAR � PROVIDE WORK IS STARTED WITHIN ISODAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLIC W, ON BEHALF F HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARM EBB THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, IMPIOYEEI, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER, NATURE, ARISING DIRECTLY 08 INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. SSUANCE OF THIS PERMIT SHALL NOT BE
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DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE DRYS ABILITY TO ENFORCE ANY ORDINANCE PROv,
VRecording
Fee
Receipt III
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; T14AT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
T14E OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application Ishos a pe"' hit signed by the
TION: AND IN GOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
Building Official or his/her Dopssy: and Fees .. pold,
,celptisecknowiodg,dinap,,nprwidod.
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON REILATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW` 18.27.
FOR INSPECTION ,�)
S C IOWNER R BE T) DATE SIGNED
25)
21: 1
771,0220
RELEASEDBY
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ATTENTION
Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
OR GINAL . FILE YELLOW � INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK-OWNCH GOLD -ASSESSOR
GREEN - ACCOUNTING
04102 PRESS HARD -YOU ARE MAKING 5 COPIES
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RECORD OF INSPECTIONS