20000498.pdfPERMIT EXPIRES
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CITY OF EDMONDS
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PE MIT APPLICATION: UB DAYS
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SEE BACK 0, PINK PERMIT FOR MORE INFORMATION
END RE�IEW FEES
FEE
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AGREE S TO 'N'E"', . GE 0 HARMLESS THE CITY 01
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I HEREBY ACKNOWLEDGE THAT I HAVE REAU THIS APPLICATION, THAT THE INFO NATION
AUTHORIZED AGENT 01
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GIVEN IS CORRECT; AND THAT I AM TI R T" G CONSTRUC
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ION AND IN DOING THE WORK AUTHORIZED THEREBY, N . ASHINGToN FELAI ING'.
STATE OPON
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FOR INSPECTION
IN VIOLATION OF THE LABOR CODE OF THE
WORKMENS COMPENSATION INSURANCE AND RCW 18 21,
OF GAl_5SiGNDINTE
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ORIGINAL FILE YELLOW -
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Name Title Date
VERIFIED BY CITY BUILDING INSPECTOR-�
Name Date
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FINAL PROJECT APPROVAL FORM
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DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: ----YME DEPARTMENT DATE
,��Z����ENGINEERING DIVISION DATE
LANNING DIVISION DATE—
PROJEC
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,MIT IRNSPECT
DESCRIPTION OF WORK TO BE INSPECTED nAhg- L
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of:
_Y_Final approval of the described work
Bonds associated with the project may be released
___I —GRANT FINAL PROJECT APPROVAL
—GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
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_FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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____RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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FOUNDATION:
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Slab Insulation ..........
PLUMBING:
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Commercial Final
HEATING:
Gas Test ....................
Gas piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
VIS -7--P
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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OCCUPANCY ..................
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PLAN CHECK NO: 1 1 ...... _-
THIS PERMIT AUTHORIZES ONLY 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 PERMISSION.
PERMIT APPLICATION: 18IsOAYS
PERMIT LIMIT, I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
N EH
0 lLFOFHIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
I INTER NWA.
N ES FEES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON. ITSOFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND
ALLCLAIMS FOR DAMAGESOF WHATEVER NATURE.A LSINGDIRECTLYORINOIRECTLY
sc FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
o DEEMEDTOMODIFY. WAIVEOR REDUCEANY REQUIREMENTOF ANY CITY ORDINANCE
'OR LIMIT INANYWAYTHE CITY SABILITY TO ENFORCE ANYORDINANCE PROVISION.
SPECIAL INSPECTOR JAREA
REQUIRED [] YES
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REMARKS
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REQ'Dl I
I .
l3ee� lw-)- q
I
VALUATION
FEE
PLAN CHECK FEE
1304— 1
BUILDING
92
15159
P UMBING
19,
MECHANICAL
.1141)
GRADINGIFILL
STATE SURCHARGE
ENG. REVIEW FEES
ENG. INSPECTION FEE
It
PLAN CH CK DEPOSIT
RED
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLIC ION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
This ppIc.b.. is - . PK uI ep.d El IIIs
THE OWNER. I AGREE To C MPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
0
ED
CALL
BWIdIlI, 11 hIllhel D,p,ly ,d Fees PlId. d
TION: AND IN DOING THE WORK AU HORIZED THEREBY. NO PERSON WILL BE '11PLOY
T
RE ATING TO
FOR INSPECTION
'�
r oipt i,..k..Illdgld ,pace p—dod.
I
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
WORKMEN'S COMPENSATION INSURANCE AND RCW 16,27.
111�2 lR T)
GAT'E ANED
(425)
LNA =RAG
771-0220
EXT 333
A17ENTION
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
31NAL FILE - YFULO—INSPECT.R
AIS-11
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER GOLD