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1PERMITEXPIRES ////
CITY OF EDMONDS
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THIS PERMIT AD THO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS W77TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADINGIPILL
DOMAIN (CURB% SIDEWALKS, DRIVEWAYS, MAROUEES. ETC�) WILL REOUIRE
G SEPARATE PERMISSION.
'%_nURcHAr;GE
PE MIT APPLICkrIOW ISO DAYS
PERMIT LIMPE I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
E REVIEW FEES
SEE SACK OF PINK PERMIT FOR MORE INFORM kTION
'A PLACANT. ON BEHALF F HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
END INSPECTION FEE
IN INTEREST� AGREES TO INDEMNJFY� DEFEND AND HOLD HARMLESS THE CITY OF
'LANDSCAPING
2 E MONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANYAND
INSPECTION FEE
DIRE
A LCLAIMS FOR DAMAGESOF WHATEVER NArURE.ARISING CTLYOR INDIRECTLY
7E—CEIPT
x FR M THE ISSUANCE OF THIS PERMIT. ISSUANCE Or THIS PERMIT SHALL NOT CE
c D EMED TO MODIFY, WAIVE ON REDUCE ANY REOUIREMENTOF ANY CITY ORDINAN E
PLAN CHECK DEPOSIT
el NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,"
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ Till S APFLICATION� THAT THE IN FORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT AND THAT I AM THE OWNER OR THE DULY AUTHORIZED AGENT OF
CONS r.-C
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THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGUiLATING
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THEREBY. NO PERSON WILL BE EM L
CALL
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ION,ANDIN DING THE WORK AUTHORIZED
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FOR INSPECTION
WORKME-NSCOMP�ASATtgK'gZkRANCEAN RCWIS.27�
OFFICIA1 SIGNATURE DATE
SIGNATURE 1 OR( ATE SIGNED
(425)
4Y _�f
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771-0220
DATE
Ai*-EWON
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-
ORIGINAL FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK OWNER GOLD -ASSESSOR
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DATE APPROVED
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EXTERIOR SHEATHING
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FRAMING ........................
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INSULATION ..........
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Wall insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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OCCUPANCY ..................