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CONSTRUCTION PERMIT APPLICATION
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REMARKS
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PERMIT APPLICATI N: ISD DAYS
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SEE BACK OF PINK PERMIT FOR MORE UVFORMATION
'APPLICANT ON BEHALF OF "IS O&HER SPOUSE, 81 . IRS, ASSIGNS "0 SUCC11ORS
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Fire Review
Plan Chk. Depos
IN INTEREST AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
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EDMONDS, �IAGHINGTON He OFFICIALS, EMPLOYEES, AND AGENTS MOM MY AND
Fire Inspection
Receipt IN
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
No T Y
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY �.'NANCE
ITY ORDI"NC
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'OR LIMIT IN ANY WAY THE C�S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
Recording Fee
Receipt #
IHERE ACKNOWLEDGE THAT I RAVE READ THIS APPLICATION: THAT THE
APPLIPATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
rrIE OWNE � I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
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CALL
TION; AND 4DOING THE WORK AUTHORIZED THEREBY, NO PERE N WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTION GP_ �:Ijapd.
a WORKMENS COMPENSATION INSURANCE AND RM 18,27.
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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 CEFITIFI-
CRGIN�-FILE YELLOW- INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK OWNER GQI-D-ASS SSOR
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