20000984.pdfFPERMIT EXPIRES 44-4
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PERMIT
CITY OF EDMONDS ZONE
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CONSTRUCTION PERMIT APPLICATION JOB
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REMARKS
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PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REQ
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VALUATION FEE
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PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE W" RK NOT D. THIS PERMIT CoVERS WORK TO
—
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTIO ON THE PUBLIC
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-
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ENG REVIEW FE
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
A FPLIElRA.lTjOAGlENlLl I ' HISOR HER SPOUSE. HEIRS,ASSIGNS AND SUCCESORS
END, INSPECTION FEE
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R A.A.Ei
I A ISSUANCE OF THIS PERMIT SHALL NOT BE
INSPECTION
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. FROM THE ISSUANCE OF THIS PERMIT.
C! DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
5 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
RECEIPT
TOTAL AMOUNT DUE
ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION� THAT THE INFORMATION
APPLICATION APPROVAL
I HEREBY �E DUL AGENT OF -
GIVEN IS CORRECT: AND THAT I AM THE OWNER. OR TH
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IN VIOLATION OF THE LABOR CODE OF THE STATE
WORKMEN �S COMPENSATION INSURANCE AND ROW 18.27.
-
ICIALS S ATURE D� E
DATE SIGNED
(425)
SI NATUIn (0 NER R GEN I
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771-0220
DATE
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ELEASED By
EXT1333
PIT-ENTION
OCCUPY A BUILDI NG OR STRUCTURE U NTIL
771-0221
T IS UNLAWFUL 10 USE OR
APPROVAL OR A CERTIFk
ORIGINAL -FILE - YELLOW INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK OWNER - GOLD ASSESSOR
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SETBACKS .....................
FOUNDATION:
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Wall..........................
Pler/Porch .................
Retaining Wall ...........
Slab Insulation ..........
P LUMBING:
Underground .............
Rough -In ...................
Commercial Final
HEATING:
GasTest ...................
Gas Piping ............
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING i.:.*
`.'AR FLO6iR FRAMING
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INSULATION ..................
--,floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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�:EGO.E 0. PR V. PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADING/FILL
DOMAIN (CURDS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION
ITATE'SURCHARGE
PERMIT APPLtCATiOKN:, 180 DAYS
PERMIT LIMIT'. I YEAR. PROVIDED WOR S STARTED WITHIN 180 DAYS
ENO. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
;APPLICANT,
N 'NTIRESTAAGRE.ETSOTO Nr OEM N" DEFEND AND HOLD HARMLESS THE CITY OF
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A LYOR IND RECTI-Y
LLCLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECT
RECEIPT
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
D EYED TO MODIFY. WAIVE OR REDUCE ANY RECUIREMENTOF ANY CITY ORDINANCE
0 E PROVISION.-
RECEIPT//
NOR LIMIT IN ANYWAYTHE CITY'S ABIV.TY TO ENFORCE ANY ORDINANCE
TOTAL AMOUNT DUE
THAT I HAVE REA. THIS APPLICATION: THAT THE INFORMATION
APPLICATION
APPROVAL
HEREBY ACKNOWLEDGE
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHOR ZED AGENT OF
hillp li', I, hot. ps,hI!l signed by the
HE NER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
T OW
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dino Olfp'ic
Bth' end
TION;ANDIND ING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
OOF OF WASHINGTON RELATING TO
FOR INSPECTION
.kh—ledgitit In is
IN VIOLATION THE LABOR CODE OF THE STATE
WORKMEN'S COMPENSATION INSURANCE AND RCW 18,27.
SI.'ATUlE D E
S,
NATUR to NER RAGEfTT)---
D, E SIGNED
D�
(425)
Q11111.1
)- Iq aD
771-0220
DATE
RELEASED By
ENTION
EXT#333
IT 15 UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORJA CERTIFI-
ORIGINAL -FILE - YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBCSECTION 09
FAX
PINK-OWNES - GOLD -ASSESSOR