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FP—ERMIT EXPIRES
SE PERMIT
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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1-144AK
VALUATION
PLAN CHECK FEE
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BUILDING
PLAN CHECK NO: ED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE P OPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADINGIFILL
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
:3 SEPARATE PERMISSION.
URCHARGS
IERMITAPPUCATI N: ISO DAYS
PERMIT LIMIT. I YEAR - ROVIDED WORK IS STARTED WITHIN 160 DAYS
P
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF F HIS 08 HER SPOUSE, HUIRS. ASSIGNS AND SUCCESORS
OF
9NO INSPECTION FEE
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WASHINGTON.
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M EDMONDS.
A S.F,�H DA'MA E OFWHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
PERMIT SHALL NOT BE
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11 ANY CITY ORDINANCE
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8 PT
THIS APPL'CAT'OLNY. THAT THE""OR.ATION
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FOR INSPECTION
CODE OF THE OF WASHI GTON RELATING
IN OLAT ON OF THE LABOR STATE
V, 1
ATE
WORKMEN-1 COMPENSATION INSURANCE AND ECW IB-21
OFFICtA SIGN E
(425)
IIGN�ATLFIE 10 An
771-0220
REL BED BY DATE
EXT 333
ATTENTION
ITIS UNLAWFULTO USEOR OCCUPY A BUILDING OR STRUCTUREUNTIL
771-0221
A FINAL I NSPECTION HAS BEEN MADE AND APP ROVAL 08 A CERTIFI-
ORIGINAL -FILE - YELLOW -INSPECTOR
- GOLD - ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch
Retainlrig Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
Gas Test ....................
17-0
Gas Piping .................
dO
Equipment .................
commercial Finisl�.�
EXTERIOR SHEATHING
NAILING ..........................
FRAMING............ : ...........
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
TIC o N P -L
BE D.NE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
ET WI LL F-oU E
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URCHARGE
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SEPARATE PERZMA
ssioN.
PERMIT APPLICATION: 1110 DAYS
PER.
PERMIT LIMIT. I Y `AR - PROVIDED WORK IS STARTED WITHIN 18D DAYS
YE
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. REV16W FEES
OF.
;A .A PLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
P I T TONG ML�E T Y OF
N NTEREST. AGREES T I EMNWY. DEFEND AND HOLDHARMLESS THE CITY OF
I I A. N S F . I A AND
2 EDMONDS. WASHINGTON, ITS FICIALS. EMPLOYEES, AND AGENTS FROM ANYAN
SoF
I CT
a CLAIMS OF E FE-TLY OR NO RE 'Y
4 ALL CLAIMS FOR DAMAGES OF WHATEV R NATURE ARISING DIRECTLY OR INDIRECT
T , E OF THIS PERMIT SHALL NOT BE
FROM THE ISSUANCE OF THIS PERMIT ISSUANC
IREMENT OF ANY CITY ORDINANCE
IV . N
EM9D TO MODIFY. WAIVE OR RED
D5DEEM To oD'FY WA E UCEANYREQU GROIN �C P.oVI.,o
0 NOR LIMIT FIN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
0
ENG. INSPECTION FEE
LANDSCAPING
INSPECTION FEE
R
PLAN CHECK DEPOSIT
F
R
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZE. AGENT OF
THEOWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUG
TION, AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW IB.27.
CAj
CALL
FOR INSPECTION
(425)
771-0220
ATTENT[6N EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFL
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
VALUATION I FEE
kPPLICATION
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