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CITY OF EDMONDS
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END. REVIEW FEES
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SIG A I SRO AGENT) DATE SIGNED
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DESCRIPTION OF WORK TO BE INSPECTE
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
-Final approval of the described work
erformance Bonds associated with the project may be released
—GRANT FINAL PROJECT APPROVAL
_GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
_—FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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T I PERMIT AUT ' 0 - Z 0 N tEUCTION
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BE DONE ON PRIVATE PROPERTY ONLY. ANY DONETS
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OMAN 'CURB' W A I
SEPARATE PERMISSION.
STATE SURCHARGE
PER -IT APPLICATION: 18DDAYS
M
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ERMIT LIMIT.' I YEAH, PROVIDED WORK S STARTED WITHIN 100 DAYS
P R L .
ENG. REVIEW FEES
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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L B R L FHI OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ON BEHALF 0 S
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;APPLICANT.
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
ANYAND
LANDSCAPt G
EDMONDS. WASHINGTON. ITS OFFiCIALS� EMPLOYEES� AND AGENTS FROM
OR INDIRECTLY
INSPECTION FEE
ALLCLAIMS FOR DAMAGESOIWHATEVER,NATURE.ARISING DIRECTLY
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OF THIS PERMIT SSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
RECEII
FROM THE ISSUANCE
EEMED TO MODIFY. WAIVE OR REDUCE AN REOIPREMENTOFANYCITYORONANCE
G D �DT Mo., Y W -
NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
OR LIMIT WANY WAY THE C"
ACKNOWL60GE THAT I HAVE READ THIS APPLICATION: IHAI I
vj�:,
I HEREBY
GIVEN IS CORRE.1 AND THAT I AM THE NIR, R THE UUI AUTH.8IZe A7ENT
p—it ��IP �,0IIV P, I
THE OW ER. It AGREE TO COM LY WIT. CITY AND STATE LAW CONSTRUG.
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WASHINGTON RELATING TO
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IN " ION 0 THE LABOR CODE OF TH OF
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OFFICIALS SIGNATURE DAT
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SIG A U I ERO AGENT)' DATE SIGNED7 � k I I I 1 5-4(1
771-0220 _�LEAIEI BY, 'DATE
EXT1333
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ITIS NLA FULTO USE 08 OCCUPY A BUILDING OR STRUCTURE UNTIL 771 0221 .. YELLOW INSPEC OR
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER