20020524.pdfGAITE RECEIVED
PERMITEXPIRES
CITY OF EDMONDS
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REMARKS
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PROGRESS INSPECTIONS PER USC 1108/FINAL INSPECTION FlEaD
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VALUATION $
Description
FEE Description FEE
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THIS PERMIT AUTHORUES ONLY THE We K ".11E., THIS PERMIT COVER WORKTO
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DOMAIN (CURDS. SIDEWALKS, DRIVEWAYS ETC.) WILL REQUIRE
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Engr. Review
City Surcharge
PE MIT APPLICATION: ISO DAYS
PERMIT LAIRT I YEAR - PROVI ED WORK IS STARTED WITHIN IN DAYS
Engr. Inspection
State Surcharge
BACK OF PINK PERMIT FOR MORE INFORMATION
_SEE
'APPLICANT, ON BEHALF Of HIS OR HER SPOUSE, HEIRS, ASSIGNS A140 SUCCESORS
Traffic Mitigation
Plan Chit Deposit
IN INTEREST, AGREES TO INDEMNIF'r, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON. AS OFFICIALS. AND AGENTS FROM
Receipt #
EMPLOYEES, ANY AND
ALL 01 MIS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
Fire - Review
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SMALL NOT BE
Fire Inspection
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TotalAmountDue
9 DEEMED TO MODIFX WAIVE A REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
WAY THE CrrrS ORDINANCE
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NOR LIMIT IN ANY ABILITY TO ENFORCE ANY PROVISION,'
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I HEREBY ACKNOWLE BE THAT I RAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
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 CONSTRUG.
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CALL
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TtON; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTIO14 I I .... pI I.p&n.MNQ.d J-P- p—Id.d,
WORKMENS COMPENSATION IN�URAMCE AND RCVV 18,27.
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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-
ORIGINAL -FILE - YELLOW � INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
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ENGINEERING DIVISION DATE—
PLANNING DIVISION DATE
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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
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PERFORMANCE BONDS and the granting of:
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a Copy of CORRECTION NOTICE given to owner/contractor by inspector
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MISCELLANEOUS
FINAL APPROVAL FOR
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