20000271.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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THIS PERMIT AUTHORIZES 'ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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INSPECTION FEE
RECEIPT
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ALLCLAIMS FOR
PRO THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
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PLAIN CHECK DEPOSIT
DEE, To MODIFY, WAIVE OR REDU CE ANY REQUIREMENTOFANY CITY ORDINANC
'OTINANYWAYTHECITY'SABILIT ANY ORDINANCE PROVISION.'
RECEIPT
T ENFORCE
NOR UMI Y 0
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE plEAD THIS AppLICATIUOLNy. THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN CORRECT. AND THAT I AM THE OWNER. On T G AUTHORIZED AGENT OF
IS
his application I. a., . P., In.
THE OWNER. I AGREE TO COMPLY WITH CITY AN6 STATE LAWS REGULATING CONSTRUC'
THEREBY. No PERSON WILL BE EMPLOYED
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
WORKMEN'S COMPENSATION 12 IS *11,
OFFICIA ION
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771-0220
RELEASE
ATTENfION
EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY ABU il-DING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
ORIGINAL - FILE 41ELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION:,,180 DAYS
PERMIT LIMIT. I All- PROVIDED WORK STARTED WITHIN 100 DAYS
YE
ENG. REVIEW FEES
SEE GAG K OF PINK PERMIT FOR MORE INFORMATION
__ IS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
ON BEHALF OF H
;APPLICANT.
N INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND
INSPECTION FEE
1. AGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
ALL CLAIMS FOR DAM
OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
ECEIPT 1612
1 FRO. THE ISSUANCE
DEEM80 T MODIFY. WAIVE OR REDUCE ANY PEOUIREMENTOF ANY CITY ORDINANCE
NOR LIMIT ION ANY WAY THE CITY'S ABILITY TO INPOIRCE ANY ORDINANCE PROVISION
TOTAL AMOUNT DUE
IR CEIPT
ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
I HEREBY
GIVEN I CORRECT, A D THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
This ppi,,t,, , poneit enlil signed bytill
TH5OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
D,,Id,lg OVIC1.1 .,.his/her Deply: end Fee, ,, P id. end
0 WILL BE EMP DYED
TI.N. ANDIIN DO NG THE WORK AUTHORIZED TH EEY.NOPERS N
OF WASHINGTON RE ATING
I BER L TO
FOR INSPECTION _eipt is si,;k—ledged in sP.. P—le -d
IN LAT ON OF THE LABOR CODE OF THE TAT
VIC
WORKMEN S COMPENSATION `PFANI�E AND RCW 113.27.
P,
(425)
1114�2
771-0220
FEIIAS lll� f DATE
ATTENTION I f
EXT 333
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
BEEN MADE AND APPROVAL OR A CERTlFl-
ORIGINAL FILE ---YtLLOW INSPECTOR
A FINAL INSPECTION HAS
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK OWNER - GOL ASSESSOR
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ..................
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Pier/Porch .................
Wail
Slab insulation
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PLUMSING�
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commercial Final
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HEATING:
Gas Test ....................
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Wall Insulation
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FINAL APPROVAL FOR
OCCUPANCY