20051075.pdfF ERMIT EXPIRES -
DATE RECEIVED 1 5
PERMIT EXPIRES .5 272_01(.7
USE PERMIT
CITY OF EDMONDS* ZONE NUMBER 079
CONSTRUCTION PERMIT APPLICATION JOB -04-7 OF SUITE/APT#
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NUMBER NUMBER OF CRITICAL
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PROGRESS INSPECTIONS PER 1.1131iff1ft/FINAL INSPECTION REQ1D
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Building Permit City Surcharge
rPLA NC CHECK NO: VESTED DATE Plumbing �2
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS .. WORKTO Mechanical �2 crit,
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
PERMIT APPLICATION: ISO DAYS Engr. Review
PERMIT LIMIT I YEAR - PROVIDED WORK 15 STARTED WITHIN 100 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection
APPLICANT, 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
3 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OFWIIATEVER NATURE, ARISING DITIECTIYOR INDIIIFCILY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT HE
DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCF Landscapelnsp. Total Amt. Due
0 NOR LIMIT IN ANY WAY THE CI [YS ABILITY TO ENFOFICE ANY ORDINANCE PROVISION'
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Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THAT THE INFORMATION
OWEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DU& AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC ' I his application is not a pounit unlit signed by tho
TION; AND IN DOING TIIE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL thlilding Official of hisihor Deputy: and Foos arc paid. and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION ructApi is aCknowledgod In spaco providod.
WORKMEN'S COMPENSATION INSUILANCE AND FICW 18 27.
OFFIWS SIGNATI. 1: DATE
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ATtENTION 771-0220 HELEASJ DATE
EXT 1333 Iny)
IT IS UNLAWFUL TO USE OR Y A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
04/02 PRESS H ARD -YOU ARE MAKING 5 COPIES
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