20000108 (3).pdfATE RECEIVED f. ( ° PERMIT EXPIRES
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CITY OF EDMONDS ZONE /J / NUMBER
CONSTRUCTION PERMIT APPLICATION JOB ADOflESS (/ SUITE/APTa
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. TNISPERMITCOVERB WORKTO
PROPERTYONLY. ANY CONSTRUCTION ON THE PUBLIC
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BE DONEONPRIVATE
DOMAIN (CURBS,SIDEWALKS, DRIVEWAY6, MARQUEES, ETC.)WILL REQUIRE
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STATE SURCHARGE O
2 PERMIT APPLICATION: 180 DAYS
a PERMIT LIMIT: 1 YEAR- PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES II
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF NIS Ofl HER SPOUSE.HEIRS. ASSIGNS AND SUCCESORS
TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CRY Of
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PIN
UNDSC{PING
LAND
IN INTEREST, AGREES
i ITSOFFICIALS.EMPLOYEES, AND AGENTSFROM ANYAND
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EOMONDS,WASHINGTON.
¢ ALLCLAIMSFOR DAMAGESOF WHATEVER NATURE.ARIBINGDIRECTLYORINDIRECTLY
OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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RECEIPT
PLAN CHECK DEPOSIT t
PROM THE ISSUANCE
j DEEMED TO MODIFY, WAIVE OR REDUCE ANV REOUIREMENTOF ANYCITV ORDINANCE
TO ENFORCE ANY ORDINANCE PROVISION.'
RECEIPT ']
NOR LIMIT IN ANYWAYTHE CITY5 A01LITY
TOTAL AMOUNT DUE
THAT THE IN
1 HEREBY ACNNOWLEDGETMAT(RAVE READ THIS APPL'IS
RMATIOF
APPLICATION APPROVAL
OUN:
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED
AGENT OF
Tn,a app��cnnon is not a permit unlit al0notl Ey Ine
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
EMPLOYED
CALL Owlain001lival of K,sfier Dapply: and Faos aea paid .entl
TION: AND IN DOING THE WORK AUTHORIZEDTMEREBY. NO PERSON WILL BE
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION eoeoipl ,a aeknowlotlpod in apace provitled.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
OFF CIALS SIGNATURE, ` DATI c
NA RE (OW d
DATE �IGNEO
(425)
_
771-0220 RE SE v DI QE
ATTENTION
EXT 333 \ L -
MORK3INAL)raL
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 =---
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
YELLOW.INSP. ECTOR
aOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
Brea
PINK � OWNER - GOLD - ASSE$:
FAX
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retainirig Wall ...........
Slab insulation ..........
PLUMBING:
Underground .............
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Rough -in ....................+
Commercial Final ...... -
-
HEATING:
GasTest ....................
GasPiping .................
Equipment.................
Commercial Final .......
EXTERIOR SHEATHING
NAILING..........................
FRAMING........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation .........
Wall Insulation ........... _
Ceiling insulation .......
SHEETRQCK NAILING ..,
---.SPECIJAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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