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PEFIMITAPPUCATI N: INDAYS
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Engr. Inspection
Sea BACK OF PINK PERMIT FOR MORE INFORMATION
.1 HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCFSORS
Fire Review
Plan Chk. Deposit
1_a'1`NTERZS-T,"AUEE8 TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS WASHINGTON, ITS 011111AII, EMPLOYEE1,ANII AGENTS FROM ANY AND
IALL CLAdMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
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FRO THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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I HERE ACKNOWLEDGE TIIAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLIC ATION APPROVAL
GIVEN IS CORRECT AND T14AT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGRiC TO COMP WITH CITY AND STATE LAWS REGULATING CONSTRUC
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON REUNT$NG
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE - YELLOW. INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. LED SECTION 109
PINK -OWNER - GOLD -ASSESSOR
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FINAL PROJECTAPPROVAL FORM
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DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —YIRE DEPARTMENT DATE Z-
ENGINEERING DIVISION DATE�--
PLANNING DIVISION DATE—
P R 0 J E C T _E LU—L 1 1 4—W &17—
SITE ADDRESS 9,2,
PERMIT #-2 10 �02 — �51- ADB#—DATE INSPECTED�
DESCRIPTION OF WORK TO BE INSPECTED e
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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
PERFORMANCE BONDS and the granting of:
--Z-GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ....................
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wall ...........
Pier/Porch .................
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Slab Insulation ..........
PLUMBING:
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INSULATION ...................
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Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................
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