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THIS PERMITAUTHORIZEES ItRYTHEWORKNOTFO.THIS PERMIT COVERS WORK TO
t 6 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON PU LIC
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Grading
Recording Fee
ILL RE
SCHARR (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) IN QUIRE
b SEPARATEPERIJUSSION, —
Engv. Review
City Surcharge
PER ITAPPLICATION: INDAYS
M PERMIT uslee I YEAR-PROVID WORK is STARTED WITHIN IGODAYS
Engr. Inspection
Slate Surcharge
SEE BACK OF PINK PERMIT FDA MORE INFORMATION
*APPLICAM, ON BEHALF OF HIS OR HER SPOUBE, HEMS, ASSIGNS AND SLOCES.Re
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EOMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
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Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
OF PERMIT
FROM THE I SUANCE THIS PERMIT. ISSUANCE F THIS SHALL NOT BE
DEEMED TO MODIFV, WAUVE OR REDUCE ANY REQUIREMENT OF My CITY ORDINANCE
Fire inspection
Total Amount Due
N OR LIMIT IN ANY WAY THE CrTfS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC'
CALL
This applIcauder Is net a patralt until signed by Our
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR ODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Building Official at his/her Deputy: and Fees are paid, and
receipt Is Ilk—luedged In $pace pralldled.
WORKMEITS C2MMNSATIO INSURANCE AND RCW 18.27.
SIGNATURE DATE
AGEI�) DATE SIGNS
(425)
FIALI
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771-MC,
RELEASED BY
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
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APPROVED DATE:
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PERFOPJAANCE BONDS and the granting of
--�-GRANT FINAL PROJECT APPROVAL
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a Copy of CORRE CTION NOTICE given to owner/contractor by inspector
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
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