20050466.pdfDATE RECEIVED
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CITY OF EDMONDS NUMBER. 6 1/0 ((
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Grading
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
Engr. Inspection
PERMIT LIMIT. SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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"APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MOD IFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
Landscapelnsp.
Total Amt. Due
Recording Fee
Receipt #
ION APPR
APPLICAT _5VAL
This application is not a permit until signed by the
CALL Building Official or his/her Deputy: and Fees arc paid, and
FOR INSPECTION receipt is acknowledged in space provided.
OFFICIA S SIGNATURE XTIE
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
OF
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.
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TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABPft.,CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATIrINSIL"NCE AND RCW 18:27.
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DATE SI ED
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771-0220 RELEASED BY I DAJE
ATTENTION
EXT. 13.33
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 I IRC1110.
ORIGINAL - FILE - YELLOW - INSPECTOR.
PINK -OWNER.- GOLD - ASSESSOR
10104 PRESS HARD - YOU ARE
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FINAL PROJECT APPROVAL FORM
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MEMO TO: PE 0 BUILDING DIVISION
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RE. -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL.
Date. Sign,
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