20000625.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION.
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REMARKS
ROGR.ES INSPECTIONS PER USC 1001FINAL I
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HIS PERMIT
BE DONE ON PRIVATE S IVEWAYS�,MAAOUEES QUIRE
DOMAIN (CURSS� SIDEWALK
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ATE PER SSION.
STATE SURCHARGE
80 DAYS
pERMITAPPLICAT'ON' ' WITHIN 180 DAYS
WORK STARTED
IS
ENG. REVIEW FEES
F.VGE
PERMIT LIMIT. I YEAR 'P INK PERMIT FOR ORE INFORMATION
SEE BACK OF P
FES
U�VOFS
A. T E GIll 'IF
BEHALF OF HIS OR HER SPOUSE ..IRS. ASHSAIGNSLE`�'.D S.
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LAND APING
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ARISIN
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INSPECTION FEE
AMAGEi Ol WKATEVE� NATURE. A L, NOT BE
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PLAN CHECK DEPOSIT
ANGIE .1 THIS 'EGUl�lANYRAEGU""o�'ENTP Y RS'NANCE
FL.L.CMLAT'.. F ANY IT SIGN.
VE.R R IINANCE PROV,
------
DEEMEDTOMODIFY
,�YWTAH'E CITY'S ABILITY TO ENFORCE ANY OR
NORLIMiTiNANYW
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AT THE INF H ATI N
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I HEREBY ACKNOWL H I AM THE NSTRUC
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(425)
DATE SIGNED
ION URE (OWNER A ENT
771-0220
EXT 333
OR STRUCTURE UNTIL
ATTENTION 771-0221
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING
APPROVAL OR A CERTIFI-
A FINAL INSPECTION HAS BEEN MADE AND
UBC SECTION 109
FA x
CATE OF OCCUPANCY HAS 13EEN GRANTED.
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TO:-
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MEMO TO: pERI&T COORDINATOR, BUILDING DIVISION
FROM: C—L
DEPARTMENT DATE
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ENGINEERING DIVISION DATE-
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_PLANNING DIVISION DAT
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PERMIT #_%,��J.ADB#-----�DATE INSPEC -2- Odc),
DESCRIPTION OF WORK TO BE INSPECT
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:
approval fthe described work
_____---Yerformance Bonds associated with the project may be released
_GRANT FINAL PROJECT APPROVAL
_GRANT FINAL PROJECT APPROVAL wrrH CONDITIONS NOTED
FINAL INSPECTION OUTSTANDING ISSUES
2.
3.
R INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ............
wall.......... ...............
PledPorch .................
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
OCCUPANCY ..................
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PRnrRFSS INSPECTIONS PER UBC 108/FINAL INSPECTION REU
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PLAN CHECK FEE
HEAT SOURCE GLAZING V, LOT SLO PE %
BUILDING
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PLAN
PLUM51NG
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
MECHANICAL
L BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
(39ADINGWILL
OMAIN (cuRes, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERWISSION. STATE SURCHARGE
8U�C '2'
2TATE
_
PERMIT APPLICATION: 1.0 DAYS
PERMIT Ult I YEA. PROVIDED WORK 15 STARTED WITHIN 1.0 DAYS
G W
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-A PUCANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS ASSIGNS A ESORS
F
HARML8NDSUC
IN INTEREST. AGR66S TO DEFEND AND HOLD SS THE CITY OF
:MOEMNIFY.
E o TS OFFICIALS. EMPLOYE., AND AGENTS FROM ANY AND
MOND6,11AIHINC
INSPECTION FEE
ALLCLAWS FOR DAMAGES OF WHATEVER NATURE. ARISING D RECTL.
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
DEEMEDTO MODIFY, WAIVE OR REDUCE ANY REQUIREMENTOF ANY CITY ORDINANCE
RI
I
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PRGVISiON,'
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER. 08 THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
TIOM; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOY TE D
RELATING 0
FOR INSPECTION
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
O.K.E.-S COMPENSATION INSURANCE AND RCW 18 27.
4-
11OWN111 GE"TI ' DATE SIGNED
771-0220
�j
EXT 333
A17ENTION
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
VALUATION I FEE
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APP ICATIONAPPROVAL
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ORtGINAL-FILE - YELLOW INSPECTOR
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