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THIS PERMIT AUTHORIZES ONILYTHE ORK NOTED. THIS PERMIT COVERS WORKTO
BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS MAROU ES, ETC.) WILL REQUIRE
t SEPARATrPERMiSSION.
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Is MAPPUCATION: INDAYS
PERMIT UMM I YEAPR -PROVIDED IN RKISSIARTEDWITHIN INDAYS
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!APPLICANT ON 11-LI OF 111101 HER IPOU11, HEIII, A11IG11 AND FUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
1 11 11
EDMONDS, WASHINGTON, ITS OFFICIAIS, EMPLOYEES, ANI AGENTS I OM ANY AN.
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
OF THIS PERMIT. OF THIS NO" T BE
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FROM THE ISSUANCE ISSUANCE PERMIT SHALL
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINA NICE
Fire Inspection
Total Amount Due
DINANCE PROVISION.-
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Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
APPROVAL
GIVE IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
T E OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAW REGULATING CONSTRUC-
CALL
This appl cation Is net a permit until signed by he
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STAT OF WASHINGTON RELATING TO
FOR INSPECTION
Bull ding OI= or his/her Depu y: and Face are paid,
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WORKMENS COMPENSATION INSURANCE AND HOW 18.27.
OFFICIAL DATE,
OF/
DATE 1IQN ED
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771-0220
RELEASE
ATTENTION
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IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221 1
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER GOLD -ASSESSOR
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FINAL PROJECT APPROVAL FORM
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE
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A field inspection was conducted to determine final compliance with approved plans. Final approval
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denotes that there are no Objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of:
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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RE-iNspEcTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign_
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FIRST FLOOR FRAMING
INSULATION ...........
Floor Insulation
Wall Insulation ...........
Calling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .............