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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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THISPERMITAUTHO IZES ONLY THE WORK NOTED, T141S PERMIT COVERS WORK TO
tZ BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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:3 DOMAIN (CURBS, SIUEWALKS, DRIVEWAYS , MARQUEES, ETC.1 WILL REQUIRE
SEPARATE PERMISSION.
GRADINGIFILL
SURCHARGE N�
PIS MIT APPLICATION: 180 DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 18V DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
IN INTERESi, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
ANDSCAPING
2 EDMONDS, WA HINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
ALLCLAIMS FOR DAMAGESOFWHATEVE14 NATUR5,ARISING DIRECTLYOR INDIRECTLY
ALLNOT F
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SH BE
D=TO MOD FY, WAIVE OR REDUCE ANY REGUIREMENTOF ANYCITY ORMNANG .
PLAN CHECK DEPOSIT
N T IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PAOVISION.�
I HERE Y 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
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC'
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF TH F THE STATE OF WASHINGTON PELAI ING TO
FOR INSPECTION
KMEN'S OM CE AND RCW 18.27.
WOR C Pe;;��NO
SIGNATURE (OW R DATE SIGNED
(425)
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771-0220
ATTENTION
EXT/333
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
FAX
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FINAL PROJECT APPROVAL FORM
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DATE:
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FROM: FIRE DEPARTNIENT DATE
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE�NE
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PROJECT
SITE ADDRESS� 106- b Ld� ZL�
.�PER]vffrdD # DATE IN!PECTED
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DESCRIPTION OF WORK TO BE INSPECTED--,� kI
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 PROJECT APPROVAL wrrH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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