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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CUBES, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT.IPLICATI N 180DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 1813 DAYS
SEE BAC K OF PINK PERMIT FOR MORE I-OPMATION
�APPLICANT. ON BEHAL'F OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
N INTEREST. AGREES 0 INDEMNIFY, DEFEND AND .01. HARMLESS THE CITY OF
I E ONO, DS.WASHINGTON. ITEOPFICIAIS EMPLOYEES ANDAGENTSFA.M ANYAND
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INSPECTION FEE
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
ICATION APPROVAL
INE" I AN T T' AM THE OWNER, OR THE DULY A THORIZE. AGENT OF
,A.. To I..ILY WITH CITYAND STATE LAWS REGULATING CONSTRUC
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FOR INSPECTIOJ-
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OFFIC GNA DATE
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A17ENTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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NIA.. iTENANCE BOND RELEASE. JRM
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TO: PERMIT COORDINATOR, BUILDIN�i� 5`ISION 10-rev-km 1Me96veMV*-M
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TYPE OF BOND TO BE RELEASEDVZZ4&,Z&4&94�l—$-412L--�—
BOND DATE POSTED___/-_:�_,'/_/'5_/X�'/ --BOND EXPIRES 3
Please field inspect at your earliest convenience for the release of the subject bond. If there
are outstanding requirements, please note In the space provided. Failure to respond by the
noted bond expiration date constitutes Department approval and automatic release of the
bond. It is each Department's responsibility to contact the developerlowner when outstanding
Issues prevent the release of the bond. Please copy the Permit Coordinator on all City
correspondence sent regarding this bond.
(, qJq[VA OND IS APPROVED FOR RELEASE
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—BOND IS NOT APPROVED - OUTSTANDING REQUIREMENTS NOTED
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WORK TO BE COMPLETED WITHIN _____DAYS SUSPENSE TO
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. ''I FINAL PROJECT APPROVAL FORM
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DATE:
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,NGINEERING DIVISION DATE —
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PERMIT # "_12 0 Q_L�Zo ADB#________pATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED_:L�����
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 PROTECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
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2. MICROFILM
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date- Sign_,
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FINAL PROJECT APPROVAL FORM
TO:—
DATE: —
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE—
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i�GINEERJNG DIVISION DATE
PLANNING DIVISION DATE—
SrrE ADDRESS
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PERMIT # Bg__________PATE INSPECT I . %
DESCRIPTION OF WORK TO BE INSPECTED---Eit,�)����
A fleld inspection was conducted to determine final compliance with approved plans. Final approval
bove signed Department to the release of
denotes that there are no objections from the a
PE RNLANCE BONDS and the granting of:
R
G�T FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL wrrH CONDITIONS NOTED
u Copy ofCONDITIONS given to owner/contractorby inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
1.
2. MICROFILM
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Sign_
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vatrtifi Cate of (ottupantp
PARTMENT OF BUILDINGS
PER UNIFORM BUILDING CODE SECTION 109
34 5"' Avenue S, Edmonds, WA 98020 - Building Permit M #2001-0870
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Occupancy established by this certificate: Dwelling Units. —N/A- No. Stories: I
BIS1 Type Construction: VN i, tBasement: Yes
Maximum Occupant Load -62-t (Per. U.B.C. 1002)
Room capacity signs, when rekluired,;must remain posted at all times.
Owner of Building: Wilcox Construction— �ddress: . 12� 0 Avisilnuo � -Edmonds. WA 980�6
THE_ Wilcox Construction HAS BEEN INSPECTED AND. APPOOVEO"Ali-tOMPLYINe WITH THE REQUIREMENTS OF THE 19BTEDITION
OF THE UNIFORM BUILDING CODE AS ADOPTED�BY THE CITY FOR:TH.E GkOUPIAND DIVISION OF OCCUPANCY AND THE USE FOR WHICH
THE PROPOSED OCCUPANCY IS CLASSIFIED.
Issued this 7th dayofE2kMKy, 2002
CHIEF BUILDING OFFICIAL
BY:
cstifl— w W Posted in, =pi—s pblic am and swim b. resirwed, inudiatedarobianod andsholl to min Vnermle0bl—sitionatallfinnes. mychangerA�parcy�momqW�abugdlngp�tBM.nm
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DATE RECENED
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CITY OF'EDMONDS
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-PERWTAPPUCATION: 160 DAYS
PERMIT LIMIT: I YEAR; PROVIDED WORK IS STARTED WITHIN 10 DAYS
SEEBACKO PINK PERMIT FOR MORE INFORMATION
A ... NIS AND SUCC.-PS
F HIS OR HER 'P USE " FS�D S� H CT C,
'APPLICANT. ON BEHALF 0 ,,,GEMqIPyGEFEIN.iND.. -A--LE T E Y `
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APPLICATION APPROVAL
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CALL
I HEREBY ACKNOWLEDGE 4 THAT: HAVYE REOADTHIS APPTICATION: THAT THE INFORMATION
AT AM HE WlEE OR ULY AUTHORIZED AGENT OF
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GIVEN I ' OR : Co pLy WITH CaYjv,,DSTATEM'n REGULATING NSTRUC
THEOW R. IAGREET BE EMPLOYED
TI : D INDOIN THEWOR RSON WIL FOR INSPECTION P
V LAT, OF THE LABOR CODE OF Tht STATE OF WASHINGTON RELATING TO DATE
W XMENS GOMPE.SATION INSURANCE AND RCW IB27 '(42�)' Offit GNA
SIGNATURE (OWNEr OfQ� E SIGNED
c! - I -�, - & 1 771-0220 A SED BY ATE
ID
ATTENTION Em 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I f 1., . ASPF/TOR
S BEEN MADE AND APPROVAL OR A CERETIFI- ORIGINAL - FILE YE
A F1 AL NSPECTION HA PINK -OWNER GO -ASSESSOR
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