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SEPARATEPERMISSION.
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PE MYAPPUCATION; TWDAYS
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SEC BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT. ON BEHAL OF HIS OR HER SPOUSE, HEIRS ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS Fo DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIREC Ly
Inspection
Receipt #
FROM THE ISSUANC OF rHIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT B
BeEMEDTO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCEE
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Recording Fee
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I HERE ACKNOWLEDGE THAT I HAVE DEAD THIS APPLICATION: THAT THE INFORMATION
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APPLICATION
APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHOR ZED AGENT OF
THE OWNER. I ACRE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTR
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TION; AND IN DING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE CUP D
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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ding Official or hisibe, Depaly Sad F11 paid, and
feenipt Is acknowledged In space ple0ded.
WORKMEN'S COMPENSAT3,WURANCE AND RCW 18,27.
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DAT�I�GN�D
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771-0220
RELEASED BY DATE'
ATTENTION
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IT IS UNLAWFUL To USE OR OCCUPY A 13UILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORGNAL FILE - YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
P21K-OvINER - GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN - ACCOUNTING
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ..................
FOUNDATION:
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Pier/Porch ..........
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NAILING ..........................
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FRAMING ........................
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INSULATION ...................
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Wall Insulation ...........
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Ceiling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY
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