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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION,
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
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Retainirig Wall ...........
Slab Insulation ..........
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Floor Insulation
Wall Insulation ...........
Ceiling Insulation
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SPECIAL INSPECTION
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FINAL APPROVAL FOR
OCCUPANCY ..................
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SEE BAC K OF PINK PERMIT FOR MDRE INFORMATION
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2 EDMO S,WAGHIAGTON. ITSOFFICIALS EMPLOYEES, AND AGENTS FROM A YAND
ALL C LAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY RECEIPT
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ISSUANCE OF THIS PERMIT. 15 SUA CE OF THIS PERMIT $HALL NOT BE
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DEEMED T=FY. WAIVE OR REDUCE ANY R UIRENIENT OF ANY CITY ORDINANCE
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.1 oRLIMIT C R SION.- EIPT
— — TOTAL AMOUNT DUE
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IHEREB ACKNOWLEDGE THAT] H E READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THe OWNER. OR THE DULY AUTHORIZED AGENT OF
ATING . , C ppjj,,, , ptil.1,ld by ih,
THEOWNER I AGREE TO COMPLY WITH CIT AND STATE LAWS REGULATING CONSIRUc CALL T111
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RELATING TO FOR INSPECTION b,pt .k,
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
WORKMEN'S COMPENSATION INSURANCEAND ACW 18.27.
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