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❑ CARPORT ❑ ROCKERY ❑ FIRE ALARM
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PROGRESS INSPECTIONS PER UBC 108ifIBC1091IRC109FINAL INSPECIION RE0'D 9
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Description FEE Description FEE
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PLAN CHECK NO: VESTED DATE Plumbing Base Fee
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
C BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC Gradin
j DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE g.
. SEPARATE PERMISSION,
a Engr. Review
W PERMIT APPLICATION: 180 DAYS
d PERMIT LIMIT. 1 YEAR • PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr, Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
rn 'APPLICANT, ON BEHALF 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
4 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp, Total Amt. Due !Lam✓
= NOR LIMIT IN ANY WAY THE CITY S ABILITY TO ENFORCE ANY ORDINANCE PROVISION." J -
Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN. IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALLl his application is not a permit until signed by the
TION; AN DIN DOIN RK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION THE R CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided.
WORKME OMP ON INSURANCE AND RCW 18.27.
OFFICIALS SIGNATURE DATE
SIG URE AGENT) DATE SIG ED (425) _ Z
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ATTENTION EXT 1333
ITISUNLAWFULTO SE OCCUPYABUILDINGORSTRUCTURE UNTILAFINAL L% �� /
INSPECTION HAS B MADE AND APPROVALOR A CERTIFICATE OF OCCU-or
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PANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC110. PINK - OWNER GOLD • SSER
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