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H�T SOURCE GWIN13 'S Id Permit
Building Permit :710 City Surcharge
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PLAN CHECK NO: VESTED DATE Plumbing
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
11 DONE 1" 11111 P101ERTY ..", ANY CONSTRUCTION .. THE IPLUSLIC .....
B Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
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SEPARNTEPERMISSION, Engr. Review
PE MITAPPLICATION: 180DAYS
PERMIT LIMLT� I YEAR- PROVIO 0 WORK IS STARTED WITHIN 16111DAYS Engr, Inspection
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT' ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Revew Plan Chk. Deposit
IN INTEREST, AD""' To INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY 01
EDMONDS ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt It
ALL C LAI M S`FA0'RH)'NGMTA0GN'S OF WHATEVER NATURE ARISING DIRECTLY On INDIRECT
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCi Or THIS PERMIT SHALL NOT LYE Total Amt. Due
DEEMED TO MODIFYWAIVE OR RE UCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp.
NOR LIMIT IN ANY W Y THE BUYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee Receipt
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN 19 CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
STATE ""No"
THE OWNER. I AGREE TO COMPLY WITH CITY AND iiUnUI,Ipdbyffi.
LAWS REGULATING CONSTRUC- CALL
TION; AND IN DOING THE W IIIIED T IREGY, NII PERSON WILL BE EMPLOYED �il it I�IhWhuD Ity:mKIF— p.id, iIrd
ON OF TH On CODE 115acknowled5d d.
IN VIOLATI THE STATE OF WASHINGTON RELATING TO FOR INSPECTION I-P .. f'.
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WORKMENS COMFEN N E AND RCW 18.27. IF RE
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SIGNATUR (OWN bR ADEN D T
771-0220 y,.ELEK'M.1
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ATTEN Off 1333
IT
IS UNLAWFUL ID USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR
CATE
OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 PINK -OWNER GO -ASSESSOR
04/02
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —YIRE DEPARTMENT DATE �Q—Z—OZ-
NGINEERING DIVISION DATE
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PLANNING DIVISION DATE
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PERMIT 9-002- 6-7z-1 ADBk—DATEINSPECTED--,/ —0 "Z-
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DESCRIPTION OF WORK TO BE INSPECTED, blC 1-('AP, 4L2�LI-3,C
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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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GRANT PROJECT APPROVAL WITTI CONDITIONS NOTED
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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