20000403.pdf'I DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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STATE SURCHARGE
P MIT APPLICATIONI: 180 DAYS
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IT I YEAR
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E� BACK o' I
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A HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
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771-0220
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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� LEG SECTION 109
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AILED FINAL INSPECTION - OUTSTANDING ISSUES
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DEPARTMENT OF BUILDINGS
UNIFO BUILDING CODE SECTION
At: 23632 Highway 99 Suite A -.,B 'W4,0ermit 4-1-1111 #200435
ate* Dwelling t)nits: "'NIA'a" No. Stories: 1
Occupancy established by this ce 0C
B "Ponstruptign: VN,, 14,
Basement: NIA
Max!
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. . . . . . . . . . . . . .
Owner of Building-, arks A ",Vv 99 Suit A. Edmonds
THE edical Clinic HA BEEN IN Ed`i-'0QQ, QUIREMENTS OF THE 1997 edition of the
a SP
-CIDE AS ADOPTED BY!, I
UNIFORM BUILDING C ; 'a
`�Wlt CCUPANCY AND THE USE FOR WHICH THE
PROPOSED OCCUPANCY IS CLASSIFIED.
Issued this er) h 2000 ZEN
CHIlf CIAL
BY:
This —filimbe shall be Posted In. —Pl— Public am and shall Ind be lantawd, muftw,t obwured and shall" mahnalhad In —dition stall lanes, Any chame of —pney w uss, wulm a bidding Pentland a
C-IN-�dO.�-yi�..dby�.CgydEd..d.Buildi,gOffkl.[.
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .................
FOUNDATION:
Feeling ......................
wall..........................
Pier/Porch .................
Retainlrig 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 OAS
OCCUPANCY ..............
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DOMAIN (CURDS, LKS, DRIVEWAYS .
SIG"'A c
SEPARATE PERMISSION. STATE SURCHARGE
PERMIT APPLMATIONz .180 DAYS
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PERMIT LIMIT, I V - ROVIDED ftRK IS STARTED WITHIN 180DAYS ENQ-apAEW�ES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. INSPECTION FEE
09 HER SPOUSE. HEIRS, ASSIGNS AND S
PPcANTToANB OCESORS
OF
FEEHALTFOOFHI
rNTERES INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY
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2 EDMONDS, WAS INGTON, TS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY INSRE�GN-1HRIT-
ALLCLAIMSFO AMA ESOFWHATEVER NATURE, ARISING DRECTLYOR INDIRECTLY RECEIPT
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NOT BE
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL PLAN CHECK DEPOSIT
ANY CITY ORDINANCE
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CITY'SABILITYTO ENFORCE ANYOROMANCE PROVISION.* RECEIPT
NORLIMIT MANYWAYTHE
TOTAL AMOUNT DUE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIO THAT THE INFORMATION APPLIC ION APPROVAL
OWNEFLORTHE.0 AUTHORIZED AGENT OF p,,.It ,III �sql d by IhO
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OWEN S CORRECT, AND THAT I AM THE OT
LAW TRUC- CALL SI�fld., 11,6.1 C
THE OWNER, I AGREE TO COMPLY WITH CITY AND. AT LAW REGULATING CONS b,hi,,,, opul,andr-,,ld�.1 -ld
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TION� AND IN DOING THE WORK AUTHORIZED THEREB , NO PERSON WILL BE EMPLOYED -`V"w`9"HP P"
TO tNSPECTION
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING FOR
DATE
OFF
WORKMEN'S COMPENSATJONINSURANCE AND RGW 18,27, GNA
ATE SIGN50 (425)
SIGNATURE (OW T)
R ED By DA
EXT 333
ATTENTION Y
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTUREUNTIL -0221
.771 ORIGINAL � FILE YELLOW � INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIF�\',
PINK -OWNER GOLD -ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UIBO SECTION 109 FAX