20000412.pdfPERMIT EXPIRES
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CITY OF EDMONDS
PERMIT
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CONSTRUCTION PERMIT APPLICATION JOB
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REMARKS
PROGRESS INSPECTIONS PER USC 1081FINAL INSPECTION REO
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VALUATION
HEATSOURCE GLAZI
PLAN CHECK NO:
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTEM THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
MARQUEES, ETC.) WILL REQUIRE
GRADING/FILL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS,
SEPARATE PERMISSION.
STATE SURCHARGE
MIT APPLICAIR N! ISO DAYS
Y,PE
PERMITLIMIT.1 AR - PROVIDED WORK IS STARTED W ITHIN 100 DAYS
ENE. REVIEW FEES
SEE BACK Of PINK PERMIT FOR MORE INFORMATION
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PLICANT, ON BEHALF OF HIS OR MYER SP50NUDSE HEIRS, ASSIGNS AND SUCCESORS
;AP To INDEMNIF. DEF N HOLD HARMLESS THE CITY OF
N INTEREST, AGREES All
LANDSCA NG
', ,A,11111111ANY
ED.ONDS,WASHtNGTON ITS OFFICIALS, EMPLOYEE ,A
ALLCLMMS FOR DAAIAGE� OF WHATEVER NATU�I.A� IN. DIRECTLY RK.,RECTLY
INSPECTION FEE
RECEIPT
FRO THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
DEE' 0 MODIFY, WAIVE OR REOU ANYREQUISEMgNTOFANY CITYORDINAN.E
NORMLEIMDITT IN ANY WAY THE CITY'S A821 RCE ISION..
0 ITY TO ENFO ANY ORDINANCE PROV
TOTAL AMOUNT DUE
RECEIP1 o 0
t HEREBY ACKNOWLEDGE TH READ THIS APPLICATION, THAT THE INFORMATION
AT I HAVE
APPLICATION APPROVAL
GIVEN IS CORRECT AND THAT I AM THE 0% U 11 RIZED AGENT OF
WNEA OR THE G Ly A THO
CONSTRUC�
CALL
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THE OWNER. I AGREE TO COMPLY WITH CITY AN6 STATE LAWS REGULATING
TION: AND IN DOING THE WORK AUTHORIZED THEREBY. No PERSON WILL BE EMPLOYED
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Fall — P.1d.
'AP.", dO d . P.d.d.
IN VIOLATION OF THE LA , E OF THE STATE OF SH GTON RELATING TO
ao 'IN
FOR INSPECTION
WORKMENS COMPENSATION FANC E AND RCW 18.27.
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FFI IALS SIGNATU CAT
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SIGNATURE (O��T)
(425)
771-0220
IF EASED BY D E
ATTENTION
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 CERTIFI-
ORIGINAL - FILE - YELLOW � INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. LIBC SECTION 109
FAX
PINK . OWNER - GOLD - ASSESSOR
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ENGINEERING
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ENGINEERING DIVISION DATE-12j���
LANNINGDIVISIONDA E
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PEMT# 2a:A —ADB#—DATE INSPECTE
DESCRIPTION OF.WORK TO BE INSPECTED
A field inspection was conducted to determine compliance with approved plms. Final approval denotes th at
there are no objections from the above signed Department to the granting of
inal approval of the described work
:5'-1__Perfbrmance, Bonds associated with the project may be released
_4;:;�—�GRANT FINAL PROJECT APPROVAL
I GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
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---��RE.INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR THAN THIS NOTICE
IT IS DUE TO THE QUALITY OF THE DOCUMENT.
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS
FOUNDATION:
Footing . ......................
wall ...............
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Pier/Porch ... ..........
Retaining Wall ...........
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Slab Insulation
PLUMBING:
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Underground .............
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Rough
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Commercial Final
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HEATING:
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Gas Test ....................
Gas Piping .................
Equipment .................
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Commercial Final
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EXTE JOR SHEATHING
NAILING...........................
FRAMING ........................
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FIRST FLOOR FRAMING. -
INSULATION ...................
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Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR A(y
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OCCUPANCY ..................
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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DESCRIBE WORK TO BE DONE
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REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D
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VALUATION
FEE
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PLAN CHECK FEE
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HEAT SOURCE
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PLAN CHECK NO:
IVESIS11111
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
R
DOMAIN JCURBS, SIDEWALKS. CRIVEWAYS, MA OUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
GRADINGIFILL
STATE SURCHARGE
I YE PERMIT APPLICATII 180 DAYS
PERMIT LIMIM AR - PROVIDED WORK S STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. REVIEW FEES
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST AGREES TO INDEMNIFY EFEND AYNDHOLD,=LESS THE CITY OF
� �LU TS FROM ANY AND
'I
I EDMONDS� WASHINI ITS OFFI( S. EMPLO E, A
ARISING DIRECTLY OR INDIRECTLY
LANDSCAP NO
INSPECTION FEE
ALLCLAIMSFOROAMAOE OFWHATE
OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAH CHECK DEPOSIT
FROM THE ISSUANCE
DEEMED TO MODIFY. WAIVE OR RE CE N RSOUIREMENT OF ANY CITY ORDINANCE
OU A Y
ISION."
'OR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
TOTAL AMOUNT DUE
I HER58Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATI N
OF
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DU�V AUTHORIZED AGENT
COMPLY WITH CITY AND STATE LAWS RFGUI.ATING CONSTRUC�
CALL
THE OWNER. I AGREE TO
TION, AND IN DOING THE W A T-ORZE-T-ERE-y6` PERSON WILL BE EMPLOYED
.FX+ TO
FOR INSPECTIO
IN VIOLATION OF THE LABOR E 0, THE STATE F WASHINGTON RELATING
RANCE AND ACWIB.27.
WORKMEN'S COMPENS�T F
SIGNATURE (OIN I(, T)
(425)
�,EN
771-0220
EXT 333
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-02V
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
FAX
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