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PERMITEXPIRES
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CONSTRUCTION PERMIT APPLICATION
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PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION III
VALUATION
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Description
FEE
Description
FEE
Plan Check
State Surcharge
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LOT SLOPE %
Building Permit
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City Surcharge
PLAN CHECK NO;,,,
VESTED DATE
Plumbing
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t HEDONSONPRIVATEP OPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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Grading
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3 MAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ) WILL REQUIRE
1= SEPARATE PERMISSION.
Engir. Review
PER IT APPLICATION: ISO DAYS
PERMIT LIMIT. I YEAR- PROVID D WORK IS STARTED WITHIN ISODAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPU NT, ON BEHALF 01 HIS OR HER SPOUSE. HERS, A11QN1 AND 1UGGES.A.
Fire Revieev
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
Fire Inspection
Receipt #
A L CLAIMS FOR DAM Gas OF WHATEVER NATURE, AN SING DIRECTLY OR INDIRECTLY
FROM THE I SUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY WAIVE OR RE UCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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Total AnIt. Due
NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee
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IHERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
HA H INFO' Ano
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
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APPLICATION APPROVAL
THE OWNEIL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTFIUC�
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TION; AND IN DING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WAS14INGTON RELATING TO
FOR INSPECTION
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ATTENTION
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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- OLE YELLOW-INSPE'GTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK'OWNEA GOLD -ASSESSOR
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