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SEE SACK PINK PERMIT FOR MORE INFORMATION
'APPLICANT, 81IIALFOFHI OR HER SPOUSE, Elk$. ASSIGNS AND SUCCESORS
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GFVJ R EANY ED IREMENT 01 ANY CITY ORDINANCE
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TOTAL AMOUNT DUE
FEC
IHEREB ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATI N
APPLICATION
APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
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T EOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
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IN VIOLAT ON OF THE LABOR ODE 01 THE STATE OF WASHINGTON
WORKMEN 9 COMPENSATION INSURANCE AND HOW 18,27.
OFF CIALS SIGNATURE e
DATE
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771-0220
RELEASE TE
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IT IS UNLAWFUL TO USE 08 OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
'WSPFCT�R
A FINAL INSPECTION HAS BEEN MADE AND A1111.1AL .11 A CERTIFI-
'.0 FILE A - OW
CATE OF OCCUPANCY HAS BEEN GRANTED, USC SECTION 109
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MEMOTO. PERMIT COORDINATOR, BUILDING DIVISION
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DESCRIPTION OF WORY
field inspection was conducted to determine compliance with approved plans. Final approval. denotes that
A _ re no objections from the above signed Department to the granting of:
there a
_—K—Jinal approval of the described work
ed with the project may be released
erformance Bonds associat
GRANT FINAL PROJECT APPROVAL
GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
_FhILED FINAL INSPECTION OUTSTANDING ISSUES
2.
3.
__Rp_,NSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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DESCRIPTION OF WORK TO BE INSPECTED-5�2(-����
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of
_Final approval of the described work
Bonds associated with the project may be released
GRANT FINAL PROJECT APPROVAL
FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
�FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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ELECTRICAL
WOR K PERMIT APKICkFION'
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Request inspection [Zk 1686826
Please press hard-4th copy Is postemd
Cuammuciid Arm..[ P. it Residential
I J.b Electri cal contractor O.ner
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installs i a descrip
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El tri at contractor name Licem. number
'V C' Nh) RICS �41C
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18021 _Q/0 di/e AIC
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I hereby certify that I sto the wrer of the above named property or a
licensed electrical contractor (or the firm's authorized agent) and am
rng�
making the electrical installation or alteration in compliance with the
electrical law, Chapter 19-28 RCW-
(Zk Char my, ntractor's account.
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Sigmd a 'd cal administrator
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Please Draw
Please Draw
H114ftwa
Map Below from the Nearest Main Street or Hi hwa
MapBelow, from the Nearest Mol"
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To assist us in providing better service to you,
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please fill out tile application paying
particular attention to the following items:
1. Complete all appropriate blanks�
7Streelor
6
2. Provide detailed des cription of installation.
3. Provide detailed map to jobsite.
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4. If no home phone number is available, please
provide message number,
5. Make check payable to the Dept. of Labor &
Industries.
6, if you are mailing this in, please remove hard
copy to post on the jobsite and send the top 3
copies to the appropriate service location.
7. Signer is owner only if not wired by an
electrical contractor. —j— I 011�" J 1
8, if wired by an electrical contractor, must be
signed by administrator or authorized designee.
if you have questions, please feel free to ask us! —I),parhoent of Labor & �Industr�ies
Electrical Section
r500-001-000 electrical work permit application rev 8-99 Inspector
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
�R staining Well ...........
Slab Insulation
PLUMBING:
a In
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Underground .............
M
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0 C,
...................
Final
M
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Commercial
HEATING:
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Gas Test ...............
Gas Piping ............
0
Equipment ..........
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Commercial Final
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ExTERioR SHEATHING
NAILING ..........................
M 0
FRAMING .............
FIRST FLOOR FRAMING
X
INSULATION ...................
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Floor insulation
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Wall Insulation ...........
Ceiling insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................
PERMIT EXPIIRE��/�'
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CITY OF EDMONDS Z NE NUMBER
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P-' MIT APPLICATIO : 180 DAY
PER
F'
PERMIT LIMIT'. I YEAR , PROVIDED W RK 19 STARTED WITHIN 180 DAYS
P IT L AR - G
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. REVIEW FEES
;A PPL . Ti. G HA FO,: NEAN..U=ES..S
PUCANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIG
NPINTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITYOF
IN .'FRES " S TO,
ENG. INSPECTION FEE
LANDSCAPING
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
ALLCLAIMSIOR DAMAGE'SOFWHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY
RECEIPT
FROM THE '.UA' �E . THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSH
DEEMEDT MODIFYWAIVEO REDUCE ANY REQUIREMENTOF ANICITY OROINANC
10
NORLIMIT N ANYWAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE SION.,
PROV��
TOTAL AMOUNT DUE
RED
lei
I HEREBY ACKNOWLEDGE THAT I HAVE REA.IHIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN 15 CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
TN. -R.il�.d b,
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING C.NSTR UC.
ED
CALL
Bug,jj, 011,6M .1 hi�., D.Pull: .�d F- .. P-.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOY
STATE OF WASHINGTON RELATING TO
..p, � F-M� pd I, P-
FOR INSPECTION
IN VIOLATION OF THE LABOR CODE OF THE
WORKMEN'S COMPENSATION INSURANCE AND ROW 18.27�
URE ATE
TZOWNEA OR Aq
(425)
771-0220
E
ATTENTION
EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
HAS BEEN MADE,AND APPROVAL OR A CERTIFI-
ORIGINAL � FILE YLLOW! 4SPECTOR
A FINAL INSPECTION
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK � OWNER GOLD-ASSSSSOR