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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS
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DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
GRADINGIFILL
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PERMITAPPLICATI-N: 10-AYS
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I HEREBY ACKNOWLEDGE THAT; HAVE READ THIS APPLICATION. THATTH9 INFORMATION
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THEOWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS R D
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771-0220
DATE
ATTpNTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
EXT 1333
771-0221
FAX
ORIGMAL-FILE YELLOW -INSPECTOR
PINK - OWNER GOLD - ASSESSOR
FIN" PROJECT APPROVAL JRM
RECEIVED TO:
JAN 6 2 2002 DATE:—
OEVELOPMENT SERVICES CTR
CI ry OF EDMOrg COORDINATOR, BUILDING DIVISION
MEMO TO:
FROM: _____YIRE DEPARTMENT DATE /2�.- �10— d
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE—
PROJEC
SITE ADDRESS 0 11!4 0,L4 (JA112 I-
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PERMIT #9-6
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine final compliance with approved plans. Final approval
the above signed Department to the release of
denotes that there are no objections from
PERFORMANCE BONDS and the granting of
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy ofCONDMONS given to owner/contractor by ffispector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
Copy of CORRECTION NOTICE given to owner/contractor by inspector 7-0
2. hJV
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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SEPARATE PERMISSION.
PERMITAPPLICATION: moDAYs
PERMIT LIMIT: I YEAR. PROVIDED WORK IS STARTED WITHIN 10 DAYS
EVIEW FEE
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
INSPECTION FEE
-APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ININTE RESWTAAGREG�IDTO :NDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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GEEMEDTOMODIZ WAIVEOR REDUCEANY REQUIREMENT OFANY CITY ORDINANCE
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NOR LIMIT IN ANYWAYTHE CITY'S ABILITY TO ENFORCE ANYORDMAN PROVISION.*
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TOTAL AMOUNT DUE
RECEIPT
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS Co RECT. AND THAr I AM THE OWNER OP. THE DULY AUTHORIZED AGENT OF
Rl
ThIs'PPIt'*"t'w
THE OWNER. AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
CALL
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TION; AND IN DOING 0 PERSON WILL BE EMPLOY
THE WORK AUTHORIZED THEREBY. N WASHINGTON RELATI NG To
OF
FOR INSPECTION
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IN VIDIAT*N OF TIE LARD R CODE OF THE STATE I
18.27.
DATE
WORKMEN'S COMPENSATION INSURANCE AND RCW
—TATE SIGNED
(425)
OFFICIALS SIGNATURE
11A lel
-
SI ATURE(OWNZO A E T)
o'l
771-0220
x.- .
DATE
ION
EXT 1333
IT IS UNLAWFUL TO USF OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELLD -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK -OWNER GOLD -ASSESSOR