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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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ENG. INSPECTION FEE
ICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
;APPLPLC T H LF OF
INTEREST, AGREES TO:NDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING
N NT ST G E To IN"
2 'EDMONDS, WASHINGTON, TS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE
ON ITS
AULCILAIMS FOR DAMAGESOF WHATEVER NATURE.AFIE,NG DIRECTLY OR INDIRECTLY
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FROM THE ISSUA CE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
NCE F H,
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DEEMEDTDMODIFY, WAIVE OR REDUCE ANY HEOUIREMENT OF ANY CITY ORDINANCE
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0 NORUMITINANY WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
0 N R LIMIT IN Y W Y T. C',
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RECEIPT
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RECEIPT
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I HEREBY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLI ATION APPROVAL
GIVEN IS CORRECT. AND THAT AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONST CALL 6�L Th,� ppji�-Ii.,, I. �.j . ..,I uMil .,p.d b, 1�.
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TION� AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED -ill I. ..0.wl.dg.d i� pn. p—d.d.
IN VIOLATION OF THE LABOR GODS 01 THE STATE OF WASHINGTON RELATING TO FOR INSPECTION -
W.FKMEN'S COMPENSATION INSURANCE AND PCW 1827. OFFICIALS S ATU DATE
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ATTENTION EXT 333 ------
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 FAX PINK - OWNER GOLD � ASSESSOR
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FINAL PROJECT APPROY L FORM
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ENO G DIVISION DATE
—PLANNING DIVISION DATE
PROJEC
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PERNUT C. ADB#____----PATE INSPECTED
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,SCRIpTION OF wORK TO BE IRNSP
rmi Hance with approved plans. Final approval denotes that
A field inspection was conducted to dete necourl)
there are no objections from the above signed Department to the granting Of:
approval ofthe described work
_____xf�'erfbrmance Bonds associated with the project may be released
GRANT FINAL PROJECT APPROVAL
_GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
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___yAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
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________RE_INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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PLICA THE CITY OF
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IS CORRECT AND THATAM TH'
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ORIGINAL - FILE - YELLOW INSPECTOR
- ASSESSOR
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