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PERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT '200490
'ON, CQ, NUMBER
CONSTRUCTION PERMIT APPLICATION
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PLAN CHECK NO: �VESTIO DATE
THIS PERMIT AUTHORIZES NLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERWIssioN.
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BUILDING
PLUMBING
MECHANICAL
GRADINGIFILL
RCHARGE
PERMIT APPLICATI N: 180 DAYS
PERMIT LIMIT. 1 YEAH - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG REVIEW FEES
SEE BACK OF PINK PERMIT FDA MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
;APPLICANT. D HARMLESS THE CITY OF
AGREES T DEFEND AND No'
ENG INSPECTION FEE
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I HEREBY ACKNOWLEDGE THAI I HAVE READ THIS APPLICATION. THAT THE INFORMATION
T or
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GIVEN IS CORRECT. AND THAT I AM THE OWNER. PLC
THEOWNER IAGREE TO C WITH CITY AND STATE LAWS REGULATING CO�STRLC
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CALL
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THE STATE OF WASHINGTON RE ATING 0
FOR INSPECTION
IN VIOLATION OF THE LABOR CODE OF
W EN'S COMPENI 11 INSURANCE AND I 1�11.
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SIGNA RE (OWNER A NT)�;�Z
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771-0220
EXT 333
%TTENTION
IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
IT
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Slab Insulation ..........
PLUMBING:
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Gas Test ...............
(Y\
Gas Piping .................
Equipment � ...........
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EXTERIOR SHEATHING
NAILING ....................
FRAMING........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ........... .
Ceiling insulation
SHEETROCK NAILING
SPECIAL INSPECTION
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FINAL APPROVAL FOR vy, 6
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DATE RECE17D
PEFfMft EiPIRES
CITY OF EDMONDS
USE PERMIT 2004901c,"
'ONE NUMBER
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ADDRESS
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THIS PERMIT ApTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
T HIS p E. T A T. oR..E
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PNA
suRCHAF.5
P ERMIT APPLICATION: 180 DAYS
A � WITHIN 180 DAYS
PEPtMIT LIMIT.- I YEA PlIoVIBED WORK IS STARTED
PERMIT "MIT ' , A
ENG, REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
SEE BAD K o'
PLICANT, ON BEHALF OF HIS OR ItER SFENDSE HDEIRISLADISAGNS AND SUCCESOMS
AP'LIE' ON BEHALF I
P
END INSPECTION FEE
;A US XN AMLESS THE CITY OF
N INTEREST, AGREES TO INDENIMI
IN INTS .. T AGREES To
LANDSCAPING
2 EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM A -AND
H N N
W I -T I
E .M. I IS o
INSPECTION FEE
ALLCLAIMSFORD RISING DIRECTLY OR INDIRECTLY
A AGESOFWHATEVERNATURI,A
RECEIPT
FROM THE ISSUANCE OF THIS PERMIT ISS ANCE OF THIS PERMIT S.ALL NOT BE
PLAN CHECK DEPOSIT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY A QUIREMEN 0; ANY CITY ORDINANCE
PROVISION-
TIN =ANY
AEC
o U I, WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE
NORUMI,
TOTAL AMOUNT DUE
APPLICATION. THAT THE INFORMATION
APPL CATION APPROVAL
I HEREBY ACKNDWLEDGE THAT I HAVE READ THIS
AND THAT I AM THECOWNER6 DUSLYtAUTHORIZED AGENT OF
Thil tj— I, III , permit uPtjj,Iq,,1d by the
GIVEN IS CORRECT.
SoTRATTEKE
T E OWNER. I AGREE TO COMPLY W11 H ITYAN LAW CGUI�TINGGONSTRLFC
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CALL Beht, , offi .1 r hillh., Deputy: ehd Fee. IP Id. Pd
N L BE IMP ED
ION; AND IN DOING THE WO RK AUTHORIZED THE REBY, NO FE RS. WIL
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TI E OF WASHINGTON RE ATILOY T
N VIOLATION OF THE LABOR C DE OF THE STAT NG 0
FOR INSPECTION
ATE
VPFIK�EN-S COMPENSATION INSURANCE AND 5CW 18 27.
0 F IALS. GNATURE
(425) CIL
SIG �T DAT NED
771-0220 IT LEASED BY DATE
EXT 333
A47ENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221 - YELL--,ISPICTOR
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORIA CERTIFI-
f ,I-L.F,LE
X �kC K. wh�EA - GOLD -ASSESSOR
FA
CATE OF OCCUPANCY HAS BEEN RANI UBC SECTION og
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