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CITY OF EDMONDS
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REMARKS
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Y.
ENG. REVIEW FEES
See BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
5NG. INSPECTION FEE
IN INTEREST AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FRO. ANY AND
ALL CLAIMS FOR DAMAGESOFWHATEVEF� N UBE, ARISING 01--, — -
I FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SMALL NOT BE
PLAN CHECK DEPOSIT
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DEEMEDTO MODIFY, WAIVE 0 85DUCE ANY REQUIREMENTOF ANY CITY ORDINANCE
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TOTAL AMOUNT DUE
TOTAL AM'
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
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GIVEN CORRECT AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
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THE OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGU�TING CONSTRUC-
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WORK. NSC EN AND ROW 18,27.
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SIGNAT HE NT TG.�q
(425)
771-0220
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EXT 333
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ITIS UNLAWFULTOUSEOR OCCUPY A BUILDING OR STRUCTURELINTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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VALUATION I FEE
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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
11-� G FINAL PROJECT APPROVAL
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PROJECT APPROVAL WITH CONDITIONS NOTED
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PLUMBING
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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
GRADINGIFILL
DOMAIN (CURIS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
_m1;--HARGE
PERMIT APPLICATI N: 180 DAYS
F. PERMIT LIMIT'. I YEAR PROVIDED WORK IS STARTED WITHIN 180 DAYS
END. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG, IN PECTION FEE
'A PLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
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THE CITY OF
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IN NTEREST. AGREES TO:NDEMNIFY' DEFEND AND HOLD HARMLESS
'M TE OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
P G
EDMONDS,WASHMGTON�
ALLCLAWS FOR DAMAGESOF HATEVER,NATURE,A ISING DIRECTLY OR INDIRECTLY
IN 8
FROM THE ISSUANCE OF THIS PERMIT. SSUANCE OF THIS PERMIT, SHALL NOT BE
PLAN CHECK DEPOSIT
DEEMED TOMODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANYCTYORDINANCE
ORDINANCE PROVISION.�
0 NOR LIMIT IN ANY WAY THE CITY'S A131LITY TO ENFORCE ANY
TOTAL AMOUNT DUE
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
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THE OWNER. I AGREE TO COMPLY WITH CITYAND STATE LAWS REGULATING CONSTRUC-
CALL
Bu'kll�g Oliscial o"FiN',ot Oeputy':,d Flo, — P.d. ,d
TION: AN I 'G THE WOR AUTHORIZED THEREBY, NO PERE N WILL BE EMPLOYED
0 L 0
STATE OF WASHINGTON RE ATING T
FOR INSPECTION
IN VIOLA N F LA CODE OF THE
WORK. �S c Ell INSURANCE AND HOW 18.27,
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OFFI DATE
(425)
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771-0220
RELEASED By
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IT IS UN�AWFVL.To USE OR OCCUPY A BUILDING OR STRUCTUREUNTIL
771-022,
A FINAL INSPECTION HAS BEEN MADE AND APPROVALGA A CERTIFI-
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GINA- -FILE - YELLO�� - INSPECTOR
ASSESSOR
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