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THIS PERMIT AUTHORIZES ONLY THEW RKNOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADINGIFILL
n DOMAIN RCURBSL SIDEWALKS, DRIVEWAYS, MARQUEES. SEC.) WILL REOUIRE
SEPARATE PERMISSION.
PE MIT APPLICATION: ISO DAYS
PERMIT LIMIT 1 YEAR - PROVIO D WORK IS STARTED WITHIN 180 DAYS
END REVIEW FEES
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
-AP LICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
2 EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FRO. ANY AND
m ALL CLAIMS FOR DAMAGESOF WHATEVER
INSPECT iON FEE
�j NATURE, ARISING DIRECTLY OR INDIRECTLY
X1 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
IIIMIIITOIIOIIIIYWAI�lO�RIIUCIAN RIQUIREMINT 01 AN' CITY O'DINA1 I
PLAN HE loll 11
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"OR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PqOV1SI.N
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TOTAL AMOUNT DUE IR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
GIVEN IS CORRECT, ANDTHATf AM THE OWNER. OR THE DULY AUTHORIZED AGENT Or
APPLICATION APPROVAL
THECWNER I AGREE TO COMPLY WITH CIT) AND STATE LAWS REGULATING CONSTRUC
CALL
TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATIONOF IRS LABOR CODE OF THE STATE OF WASHINGTON RELATINGTO
WORKMEN S C��SATION IN URANCE AND RCW 18.27
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FOR INSPECTION
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771-0220 EFASE66�- ATE
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ITIS UNLAWFULTOUSE OR OCCUPY
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A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
OF OCCUPANCY HAS BEEN GRANTED.
CATE UBC SECTION 109
FILE `YE OW-INSP TO
FAX PINK OWNER LD - ASSESSOR
51S8
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .................
FOUNDATION:
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Pier/Porch .................
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Retaining Wall ...........
Stab Insulation ..........
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commercial Final
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HEATING:
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Wall Insulation
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Ceiling Insulation
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SHEETROCK NAILING
1711
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..............