20000201.pdfPERMIT EXPIRES
CITY OF EDMONDS
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PROPOSED
NAME
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ADDRESS
REMARKS
CITY ZIP TELEPHONE
NAME
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PROPOSED ALLOWED PROPOSED
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LOT COVERAGE REOUIRED SETBACKS JET.) PROPOSED SETBACKS (FT.)
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REMARKS
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REMARKS
INSPECTIONS PER UBC 108
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PROGRESS
NUMBER N MBER OF CRITICAL
OF ELLING A IAS
STORIES UNITS NUMBER
DESCRIBE WORK TO BE GONE
FIN- L NSPECTION REQUIRED
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VALUATION
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HEAT SOURCE GLAZING % LOT SLOPE
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PLAN CHECK NO: 1111TEO DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTH.".E.=E OF NOTE. THIS PERMIT COVERS WORK TO
I I�NRTRUCTIDN ON THE BELO
REDONE ON PRWATE Y
GRAOINGIFILL
3 DOMAIN (CURBSSIDEWALKS. DRIVEWAY . MARGUEES.eTC.1 WILL R UIRE
:1
SEPARATE PERMISSION.
URCHARGE UID
PERMIT APPLICATION: 180 DAYS
P. PERMIT LIMIT: 1 YEAR - PROVIDE.WORK IS STARTED WITHIN IIID-AYS
STORM DRAINAGE FEES
APPLOAN'T"AN."E' AL'OP HISOR HER SPOUSE. HEIRS. AS SIGNS AND SUC ESORS
ENG, INSPECTION FEE
NTE.ES R ES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
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<1 OF WHATEVER NATJRE� ARISING DIRECTLY OR INDIRECTLY
ALL CLAIMS FOR DAMAGES NOT BE
HIS PERMIT. ISSU NO OF THIS PERMIT SHALL
OROINANC E
PLAN CHECK DEPOSIT
OF ANY CITY
PROVISION -
ORDINANCE
TOTAL AMOUNT DUE uo
THAT I HAVE READ THIS AP PLICA 11 N; TH,, r . INFORMATION
APPLICATION APPROVAL
I HEREBY ACKNOWLEDGE
GIVEN IS CORRECT. AND THAT I AM THE DAY NER, OR T 4E DULY AUTHI_ -,ED AGENT a'
LAWS REGULATING CONSTRUC
CALL ThIl ppl-I.- 1 � P- q "Aa �'po I,y'EP
CALL
THE OWNER I AD R E E TO C 0 M P LYUVIHIT.H�C I T Y AND STATE
THEREBY. NO PERSON WILL BE EMPLOYED
Y F
T HEW.FKA T ZED
[ON, AND IN DOINT T
STATE 0, WASHINGTON RELATING TO
FOR INSPECTION --w pi_ P'_
ODE OF THE
IN VIOLATION OF HE LABOR C 27
WORKMEN S COMPEN INSURANCE AND FCW 18.
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(425) OFFICIAL SIGNATUH
DkTESIGNED
S"A;uRF'.Y,.ERO ADEN
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771-0220 DATt
FEIJ9SED BY
ATTENkION
IT IS UNLAWFULTO USEOROCCUPY ABUILDING OR STRUCTURE UNTIL
A FINAL IN Sp ECTiON HAS BEEN MADE AND APPROVAL. OR A CERTIFI-
ORIGINAL - FILE yEI.L.W.,NSIECT.R
CATE OF OCCUPANCY HAS BEEN GRANTED. LEG SECTION 109
PINK OWNER GOtD ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
0
Underground .............
Rough -in ...................
Commercial Final
HEATING:
m
0
GasTest ....................
A
Gas Piping .................
m
Equipment ................
Commercial Final
ExTERiOR SHEATHING
0 _0
n
NAILING ..........................
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FRAMING ...................... o..
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INSULATION ............
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Floor In, sulation
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Wall Insulation ...........
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Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
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OCCUPANCY ........ -----------------