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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
MARQUEES. ETC.) WILL REQUIRE
GRADINGIFILL
DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS.
0 SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK 19 STARTED WITHIN 180 DAYS
EVIEW FEES
SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
INSPECTION FEE
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ITiS UNLAWFULTOUSEOR OCCUPY A BUILDING OR STRUCTURE UNTiL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
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MEMO TO: PERN11T COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATEY2�;�--01�
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE —
PROJECT
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PERMIT 11296-1 ________PATF INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED--I�.��—
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
?'\ GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WrFH CONDITIONS NOTED
0 Copy ofcONDMONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
c) Copy of CORRECTION NOTICE given to owner/contractor by inspector
1. MICROFILM
2.
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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FOUNDATION:
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Retaining Wall
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commercial Final
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MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC
GRADINGIFILL
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
N
SEPARATE PERMISSIO .
STATE SURCHAR E
PE MITAPPLICATI N! 190DAVS
'EVIEW
PERMIT LIMIT'. I YEARN ROVIDED, WORK IS STARTED WITHIN 190 DAYS
P
FEES
SEE BACK OF'PINK PERMIT FOR NOSE INFORMAT!ON
'APPLICA"T.ONBEHALFOF HISOR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
MrJCNbPEECTION FEE
IN INTEREST, AGREES TO DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
:NDEMNIFY.
EDMONDS. WASHINGTON. TS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANYAND
INSPECTIONFEE
ALLCLAIMSFORDAMAGESOFWHATEVER NATURE.ARISING GIRECTLYOR INDIRECTLY
RICE177
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAIN CHECK DEPOSIT
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EENED TO .00111WAIVE OR REDUCE ANYIR�.UMEIVENT .1 ANY CITY ORDINANCE
0 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY OR—.—
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TOTAL AMOUNT DUE
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I HEREBY ACKNOWLEDGE THAT� HAVE READ THIS APPLICATION. THAT THE INFORMATION
PPlItAT
I N APPROVAL
GIVEN IS CORRECT. AND THAT AM THE OWNER. OR THE DULY UT ORIZED AGENT 05
. .t -,1 1,1 Ih.
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THE OWNER. I AGREE TO COMPLY WITHCIT AND STATE LAWSREGUI-ATINGICEOMNPLOYEC;
CALL
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dl�.g Off,z h, D.p,ly: ald F111 IM PlId,
TION AUTHORIZED THEREBY. No PERSON WILL BE
AND IN DOING THE WORK RELATING TO
WASHINGTON
Epi,
FOR INSPECTION
:.,. lklodq� I- $Pt�O Pmvl"d
V,; DILATION OF THE LABOR 0 HE STATE OF
WOFKMEWSCC�A�T CW 18-27.
ION INS NCE AND
OFF
DATE
SIGNATU�)
DATEINED
(425)
AA 1
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771-0220
1 C&TE
ATTENTION"'
EXT/333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
FINAL NSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE YELLOW - INSPECT04
A
CATE OFIOCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER GOLD - ASSES OR
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