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CITY OF EDMONDS
NUMBER
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IN VIOLATION 01 THE LABOR CODE OF THE STATE OFOWASHINGTON RELATING
DATE
WORX.FNS COMPENSATION INSURANCE ANDRCW 18.27.
DATE SIGNED
(425
FlIGtAL NAT
SIGNATURE (OW DR GENT)
DATE
771-0220
R LEA I BY
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IT IS UNLAW FILL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL I NSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
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Cleaned Site/Final
#3 FOUNDATION Setbacks
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Slab Insulation
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AR-P—LUMBING Ground Work
Permit # 1�oughln
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Permit # Equipment
#6 FRAMING Exterior Sheathing
Shear Nailing
First Floor Framing
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#9 PUBLIC WORKS Side Sewer #
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FINAL OCCUPANCY APPROVAL
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SETBACKS .....................
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Wall ..........................
Pier/Porch .................
Retaininig Wall ...........
Stab Insulation ..........
PLUMBING:
underground .............
Rough -in ...................
Commercial Final
HEATING:
Gas Test ....................
Gas Piping .............
Equipment, ...............
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
Ab_
FRAMING .......... .............
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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PLAN CHECK NO: 5TED DATE
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTIONON THE PU C
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SEPARATE PERMISSION .
STATE SURCHARGE
P15 MIT APPLICATION: ISO DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG, INSPECTION FEE
ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
�APPLICANT.
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I HEREBY ACKNOWLEDGE TH�T I HAVE READ THIS APPLICATION: THAT HEINFORMATION
APPLICATION APPROVAL
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TI,'� V - � P—" -1 �T— �l "'
H CULATING CONS1 RUC�
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TION� AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL Be
OF THE STATE OF WASHINOT N RELATING TO
FOR INSPECTION
IlkP.Illdgld lP-Fl P1-1�11
IN VIOLATION OF THE LABOR CODE
WORKMENS COMPENSATION INSURANCE AND RCVl 18.27.
OFFICIA NAT DATE
SIGNATURE IIWNEWM-,�I�Ej
(425)
771-0220
DATE
R LEAST,
AtfENTION
EXT 333
ITISUNLAWFULTOUSEOR OCCUPYA BUILDING OR STRUCTURE UNTIL
771-0221
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL. FILE YELLOW INSPECTOFrc-.
A FINAL
CATE OF OCCUPANCY HAS BEEN GRANTED. LIBC SECTION.109
FAX
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