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TH7S PERMIT AUTA095ES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK To
BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CUASS ' SIDEWALKS, DRIVE MARQUEES, ETQ� WILL REQUIRE
GRADING"ILL
SEPAR-EWEAYS'ISSION.
§WE SURCHARGE
PIE MIT APPLICATION: 180 DAYS
A PERMIT LIMIT. I YEAR, PROVID D WORK IS STARTED WITHIN "' DAY'
EIG. REVIEW TIME
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'A PLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, AS SIGNS AND SUCCESORS
ENG, INSPECTION FEE
IN INTER ST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
2 EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
�-j ALL CLAIMS FOR DAMAGE OFINHATEVERNATURE, ARISING O;RECTLYOR INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
D'EMEDTOMODIFY. WAIVE OR REDUCEANY REOLAREMENTOPANYCITY ORDINANCE
PLAN CH ECK DEPOSIT
RECEIPI
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
TOTAL AMOUNT DUE
IRECEIPT
I HERES ACKNOWLEDGE THAT I HAVE READ HIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR T E DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
T E OWNER, I AGREE TO COMPLY WITH CIT AND STATE LAWS REGULATING CON9TRUC-
CALL
T111011111,111-h het. Fol- uelil oq; 11111.
TION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL B E EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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OFFICIALS SIGNATURE ATE
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771-0220
RELEASED BY DATE
A77ENTION
EXT 1333
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
5198
FINAL PROJECT APPROVAL FQRM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE-�ae— �-(
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE—
PROJEC T
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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
PERFQRMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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.... .... ..
RECORD OF INSPECTIONS
I SPECTOR DATE APPROVED
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SETBACKS .....................
FOUNDATION:
Footing......................
Wall ..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
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PLUMBING:
Underground .............
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Rough -in ................ ..
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Commeroal Final 1
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Gas �bst ........... :w
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Equipment .................
Commercial Final
EXTERIOR SHEATHING
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NAILING .................
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FRAMING .......................
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FIRST FLOOR FRAMING
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INSULATION .............
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Floor Insulation
Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY .............