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VALUATION
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PLAN CHECK NO: DATE PLUMBING
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hMECHANICAL
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I BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON TNEREUB`RC CRADiNQFlLL
5 DOMAIN (CURBS, SIDEWALKS, DRIVEWAY MAR UEES. ETC.) VAL _QU, S
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SEPARATE PERMISSION. STATE SURCHARGE
PERMIT APPLICATIO ; 180 DAYS
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A, PERMIT LIMIT, I YEAR PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENS. INSPECTION FEE
�APPLICANT. ON BEHALF OF HIS OF HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
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2 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM
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I HEREBYACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICA
GIVEN IS CORRSCTIANO THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
This ppft,fis� I,
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COMPENSATION INSUAAN��ND RCW 18,27, l�URI
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ATTENTION EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
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Incorporated August 11, 1890
Sister City - Hekinan, Japan
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ............
FOUNDATION:
Footing ...............
wall
5-3-00 Ow -
..................
Pier/Porch .............
sree,, WA� Pa. I n i rig We I I ...........
Slab Insulation
0% -.Om mD
Underound _ ...........
rg
Rough -in ..................
Commercial Final
HEATING:
Gas Test ....................
Gas Piping ..........
k4 Equipment .................
Commercial Final
EXTERIOR SHEATHING
NJULING ...................
FRAM ING . ........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
C"
OCCUPANCY .................. .
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CITY OF EDMONDS USNE /.I NUMBER 20ooU
CONSTRUCTION PERMIT APPLICATION IOBRESS SUITEIAPT#
ADD
WIER NAMIIN UlINllSl LIO NO.
PUT NAMEISUSOIVSON No. LOT'40.
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ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL 60
Be DONE EGUIRS
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION. STATE SURCHARGE
PERMIT APPLICATION. 180 DAYS -5�
PERMIT LIMIT.- 1 YEAR - PROVIDED WORK 11 STARTED WITHIN 110 DAYS S
E. BACK .1 PINK PERMIT FOR MORE INFORMATION
ENG. INSPECTION FEE
'APPLICANT, ON BEHALF 0 HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCC5SORS
DEFEND AND HOLD HARMLESS THE CITY OF ftuffiva"Iff
IN INTEREST AGREES TO;NDEMNIFY.
EDMONDS. WASHINGTON TSOFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND lmspmspom�
ALL CLAIMS FOR DAMAGE� OF W HATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY RECEIPT
NOT BE
I_- IF THIR PERMIT. ISSUANCE OF THIS PERMIT SHALL PLAN CHECK DEPOSIT _LA
OF ANY CITY ORDINANCE
TOTAL AMOUNT DUE ... SIFT S2
THAT T14E INFORMATION
I HERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLIC ATION APPLICATION APPROVAL
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OF TR�ATIO
GIVEN S CORRECT. AND THAT I AM, THE OWNER. U AUTHORIZED AGENT OF Thil IPPli-.ti.n I� n.1 . pnni, uo, In, I,n
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTSUC- CALL S.ilding Offid I in hi,�.l O.,�Jy: Ind F.., .11 PlId. Ind
THE OWNER,
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED ipj 1. .R,t.dgnd in in.l. Pl-ii-P
CODE OF THE STATE OF WASHINGTON RELATING TO. FOR INSPECTION
IN VIOLATION OF THE LABOR
YORKMEN�'S COMPENSATION INSURANC�E414D A III URE D TE
OATS SIGNED (425) c
.3/-,7 4", 771-0220 RELEASED GAT
EXT 333 0
ATTENTION
OR OCCUPY ABUILDING OR STRUCTURE UNTIL
IT IS UNLAWFUL TO USE 771-0221
AND APPROVAL OR A CERTIFI- ARI INA YELLOW - REP
G
i A FINAL INSPECTION HAS BEEN MADE /,0
OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNS GOLD ASSES OR
CATE OF