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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PLAT RAIAL bURDIVIS-4 NO 1101111 LIO 10
LID FEE
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THI PERMIT AUTHORIZES ONLYTHEWORK NOTED. THISPERM OVER WORKTO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTR CTIREC ON T' PUBLIC
Mechanical
DOMAIN cURB$, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REOURE
a SEPARATE PERMISSJON�
Grading
PERMIT APPLICATION: SEE ECDC 19.00.00S(A)(5)
PERMIT LIMIT. SEE ECDC 19.00.00S(A)(6)
Eng, Review
Recording Fee
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Ergr Inspection
Plan Chk. Deposit
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
IN INTERE T. AGREES TO INDEMNIFY, DEF No AND HOLD HARMLESS THE CITY OF
Fire Review
Receipt III
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALL C AIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INGIREC TLY
Fire Inspection
Total Amt. Due
RON THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY's ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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Receipt #
I HEREBY ACKNOWLEDGE THAT t HAVE READ THIS APPLICATION; THAT THE INFORMAJTJON
APPLICATIONI'APPROVAL
GIVEN IS DO RECT� AND THAT I AM THE OWNER, OR T E DULY AUTHORIZED AGENT OF
CALL
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THE 0 NER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING ONSTRUC'
Bu,Id,I,9 Off,1 , hV= DIP.ty ' rVes—po—
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
FOR INSPECTION
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN S COMPENSATION INSURANCE AND RCW 18:27.
(425)
OFFC�A G T RE
(OWNER
AT
771-0220
IOGENT�
RELEASED BY
�SSFIGNE
EXT. 1333
eTftNTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
ORIGIN L FILE YELLOW INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC1091 IBC110 / IRC110.
PINK -OWNER GOLD . ASSESSOR
61.5 PRESS HARD - YOU ARE MAKING 4 COPIES
Permit Inspection Details
Permit: BLD20060213
PERMITTPAX
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04/1'412006 SNOOK 0 NOT READY.
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05/05/2006 SNOOK 35 APPROVED
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Total Time: 35
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05/05/2006 SNOOK 15 APPROVED
Total Time: is
Total inspections: 3
Total Time: 50
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