20030942.pdf13
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Description FEE Description FEE
Plan Check
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Permit City
PLAN CHECK NO: VESTED DATE Plumbing
Mechanical
THIS PFRMrr AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, FTC.) WILL REQUIRE
SEPARATE PERMISSION.
- Engr. Review
PERMrr APPLICATION: 160 DAYS
916 PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 1130 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICAK ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Ld-ndscapelnsp. Total Amt. Due
0 NOR LIMIT IN ANY WAY THE C11YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee Receipt #
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I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT� AND T14AT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application is not a permit until signed by the
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TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid. and
IN 'VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO F INSPECTION receipt Is acknowledged In space provided.
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WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
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04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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DATE'RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW PerrrJt Required
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REQUIRED DEDICATION— FT UnderWourid
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METER So PRV REQUIRED
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APPLICATION APPROVAL
This application Is not a permit until signed by the
Building OMeW or his/her Deputy: and Fees are paid, and
receipt Is acknowledged In space provided.
SIGNATUA DA E
4ATURE (0 R - AGENT) DATE SIGNED 8/1
f YV00A1 &A, /9
771-02 TRASED BY DATEI
TENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTI IRE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 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
HEAT SOURCE
LAZING*%
LOT SLOPE %
Building Permit i
PLAN CHECK NO:
VEsTEb &;�TE
Plurribll`6
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. 71418 PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPAMATE PERMISSION.
Engr. Review
PERMIT APPLICATION: ISO DAYS
PERMIT LIMI'll I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANr, ON BEHALF OF Hl� OR HER SPOUSE, HEIRS. AsSI&S AND SUCCESORS
FNe Review
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
ALL CLAIMS FOR DAMAGES OF,WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THEJSSUANCE OF THIS PERMIT. ISSUANCE OF THIB PERMIT SHALL NOT. BE
Landscape Ini;x.
DEEMED TOVODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY10RDINANCE
NOR LIMIT W ANY WAY THE 06W,13 ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECTI AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
ZCALL
TION; AND IN DOINO-XHE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
F R INSPEC
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.