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CITY OF EDMONDS
NUMBER
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STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
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PERMIT LIMIT, I YEAR . P ROVIDEDW RK STARTED WITHIN 180-AYS
REVIEW FEES
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ENFORCE ANY ORDINANCE PROVISION,'
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TOTAL AMOUNT DUE
THAT I HAVE N. THAT THE INFORMATION
T"RS. APPTLlCATIU`LY
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I "REBY ACKNOWLEDGE
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1 ��
lA13OR CODE OF TH E STATE IF WASHINGTON n LA
IN VIOLATi.N .1 0
FOR
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OFFICIAL NATU
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(425)
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771-0220
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'ATTENTION
EXT 333
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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-
ORIGINAL -FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. U13C SECTION 109
FAX
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FINAL EROJECT APPROVAL IEORM
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DATE:
-A
MEMO TO: PEPIAIT COORDINATOR, BUILDING DIVISION
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FROM: —FM DEPARTNMNT DATE L
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE—
PROJEC
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PEMT # 0 —�ADB# DATE iNsucTED-2--/S
.DESCRIPTION OF WORK TO BE INSPECT 419L-06192(e
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field inspection was conducted to determine compliance with approved plans. Final approval. denotes th
there are no objections from the above signed Department to the granting of:
Y-
_----�Final approval of the described work
erformance Bonds associated with the project may be released
_GRANT FINAL PROJECT APPROVAL
_GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
AILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
_____—RE-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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Retaining Wall ...........
Slab Insulation
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final
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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171
PERMIT EXPIRES'
CITY OF EDMONDS
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PERMIT P&O337
NUMBER
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PILAT NAMEISUBDIV[SION NO.
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NU�IBER
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STORIES
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NUMBER
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REMA KS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RED'
a's
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ELOSLOPE
111STE1 DATE
PLAN CHECK NO�, E
PLUMBING
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.AN, AL
MECHANICAL
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON T14E PUB LIC
GRADINGIFILL
n EQUIRE
TC I WILL R .
a OMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL RE
SEPARATE PERMISSION.
STATE SURCHARGE
M ITAPPLICATI N; 180 DAYS
�REV16W
PERMIT LIMIT: I YEAPIER PROVIDED WDRK IS STARTED WITHIN IIIII DAYS
-66C FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE� HEIRS, ASSIGNS AND SUCCESORS
;APPLICANT.
N INTEREST. AGREES TO DEFEND AND HOLD HARMLESS THE CITY OF
LAN SCAPING
;NDEMNIFY.
E MONDS. WASHINGTON TS OFFICIALS, EMPLOYEES, AND AGENTS FROM AWYAND
D
INSPECTION FEE
ALLCLAIMSFORO MAGES.F WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
I E
NOT BE
ISSUANCE OF TH S PERMIT. ISSUANCE OF THIS PERMIT SHALL
FROM THE ISSUANCE OF TH o
I. DEEMEDT MODIFY, WAIVE OR REDUCE ANY REQUIREMENT F ANY CITY ORDINANCE
o
PLAN CHECK - 'POSIT
PLAN CHECK DEPOSIT
NOR LIMIT IN ANY WAYTH5 CITY 'S ABILITYTO ENFORCE ANY ORDINANCE
�j
-
TOTAL AMOUNT DUE
o C
T TAL A. NT.E:7
ON
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
_
F
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
C -
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
L
CALL
RSON WILL BE EMFLOYED
TtON; AND N DO NO K AUTHORIZED THEREBY. NO 'E To
RELATING TO
CTI,
FOR INSPECTII
IN VIOLATION F LABO CODE OF THE STATE OF WASHINGTON
=5pAe�COMP N ATION INSURANCE AND RCW 19.27,
D
_,TNAT_7_(. ATE lIGNED
(425)
J,
3-31- 0 60
a 771-0220
EXT 333
WrTENTION
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC �ECTION 109
FAX
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VALUATION
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