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CITY OF EDMONDS
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURB% SIDEWALKS, DRIVEWAYS, MAROUEES, ETC.) WILL REQUIRE
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STATE SURCHARGE
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PE "MIT APPLICATIONZ 100 DAYS
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PERMIT LIMIT. I YEAR PROVIDED ORK IS STARTED
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'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE� HE RS,4SSIGNS AND SQCCESORS
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IN NTIREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON. ITSOFFICIALS, EMPLOYEES, AID AGENTS IF.. ANY AND
I"peem"T'Ev
ALLCLAWS FOR DAMAGES OFWHATEVEFt NATURE. ARISING DIRECTLY OR INDIRECTLY
THIS PERMIT, ISSUANCE OF THIS PERMIT $HALL NOT 8 E
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RECEIPT//
FROM THE ISSUANCE OF
L EMED TO MODIFY, WAIVE OR REDUCE ANY REQUI REMENT OF ANY CITY ORDINANCE
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T:AL AVO�NT DUE
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I HEREBY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
Thil IPPI-1— 1. p.-it by Iha
THE OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
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TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO P EPSON WILL BE EMPLOYED
WASHINGTON RELATING TO
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IN VIOLATION OF THE LABOR COD[ OF THE STATE OF
WORKM N'S OMPENSATIO S ANCE AND ROW 18.27.
OFFICIAL AT DATE
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DATE SIGNED
(425)
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771-0220
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ATTENTION
EXT 333
IT IS UNLAWFULTO USE OR OCCUPY ABUILDING OR STRUCTUREUNTIL
BEEN MADE AND APPROVAL OR A CERTIFI-
771-0221
ORIGINAL -FILE
A FINAL INSPECTION HAS
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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DESCRIPTION OF WORK TO BE INSPECTED,4DPAa�����
A field inspection was conducted to determine compliance with approved plans. Final approval. denotes that
there are no objections from the above signed Department to the granting of
,,zCFinal approval of the described work
Performance Bonds associated with the project may be released
_z��—GRANT FINAL PROJECT APPROVAL
—GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
_-FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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________RE -INSPECTED OUTSTANDING ISSUES. GRANT FINAL PROJECT APPROVAL
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approved plans. Final approval denotes that
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GRANT FINAL PROJECT APPROVAL
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