20000991.pdfPERMIT EXPIRES
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CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION ADDRESS
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OWNER NAMEINAME OF BUSINESS PLAT NAME/SUBDIVISION NO.
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ECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GAADINGIIILL
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DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES. ETC.1 WILL REOUIR9
SEPARATE PER�ISSION. �.Ja"RC A
PER-ITAPPLICAl ION: ISO DAYS
PERMIT LIMIT. I YEAR - P ROVIDED WORK IS STARTED WITHIN 180 DAYS ENG REVIEW FEES
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SEE BACK OF PINK PERMIT FOR ORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASHSIGNS AND SUCCESORS ENG. INSPECTIOIQ FEE
AGREES TO DEFEND AND HOL D ARMLESS THE CITY OF LANDSCAPING
IN INTEREST. :NDEMNIFY.
A ENTSFAOM ANYAND INSPECTION FEE
EDMONDS. WASHINGTON TS OFFICIALS, EMPLOY 5 ES, AND G
D M WHATEVER D T
ALLCLAIMSFOR A AGE�OF NATURE.ARISING AEC LYORINDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THI PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
RECEIPT
CSAN R UIREMENT OF ANY CITY ORDINANCE
DEEMED TO MODIFY. WAIVE OR REDU YO EENU
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0 NOR LIMIT IN ANYWAY THE CtTY'S ABILITY T
TOTAL AMOUNT DUE
ACKNOWLEDGE T.Al I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
IHEREBY
GIVEN I CORRECT. AND THAT I AM THE OWNER OR THE DULY AUTHORIZED AGENT 01
AND STATE LAWS REGULATING CONSTRUC CALL
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THE OWNER. IAGREE TO COMPLY WITH CITY Of
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I ' RE ATING TO
IN LAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON
A ENSCOMPENSW�110 URANCE AND RCW IB21,
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RELEASSOBY
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ATTENTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
INS ECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
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ORIGINAL FILE YELLOW -INSPECTOR
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GRANTED. UBC SECTION 109 FAX
FINK -OWNER GOLD -ASSESSOR
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RECORD OF INSPECTIONS
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DATE APPROVED
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SETBACKS .....................
FOUNDATION:
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Pier/Porch .................
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Gas Test ....................
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Gas Piping ..............
Equipment . .................
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NAILING ..........................
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FRAMING ........................
FIRST FLOOR FRAMING
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Floor Insulation
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Wall Insulation ...........
Calling Insulation
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SNEETROCK NAILING
SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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PERMIT EXPIRES
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ALLOWED PROPOSED FRONT SIDE REAS FRONT URSIDE REAR
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
-M I AU T0 - D`E
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DOMAIN --S - BID.'
SEPARATE PERMISSION.
PALLC�IMSFORDAMAGESOFWHATEVER
E4URC
PERMIT APPLICATION: 160 DAYS
PERMIT LIMIT. I YEAR * PROVIDED WORK IS STARTED WITHIN 18D DAYS
L Y
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG, INSPECTION FEE
APPLI ANT, ON BEHALF OF HIS OR HER SFG0NDIANHE1HRoLDSSIGNS AND SUCCESORS
L c o H L
A
IN INTEREST. AGREES TO INDEMNIF HARMLESS THE CITY OF
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LANDSCAPING
EDMONDS. WASHINGTON. ITS OFFItLD. EMPLOYEES. AND AGENTS FROM ANY AND
E . DS ASHING ON I
INSPECTION FEE
IF CLAIM OR . . 1 —1-11.—
NATURE,AFIISINGDIFECTLYo.
OF THIS PERMIT SHoAUDNOT BE
RECEIPT
PoS
PLAN CHECK DEPOSIT
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE
1 DEEMED To MODIFY. WAIVE OR REDUCE ANY REQUIREMENToF ANY CITY R NANCE
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0 NOR LIMIT IN ANY WAY THE CITY'S ABILIT
ToT�I�AAQU�T REC
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READ THIS AFPTLICEATIULNY, THAT THE INF RMATION
APPLICATION APPROVAL
I HEREBY ACKNOWLEDGE THAT I HAVE
GIVEN I S CORRECT. AND THAT I AM THE OWNER . OR D AUTHORIZED AGENT OF
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THE CIA I G C NI; -
TL EV, TRUC
NER. I AGREE TO COMPLY WITH CITY AND STATE L.A ' R.EoN`
CALL
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TION; AND IN DOING THE WORK AUTHORIZED THER BY. N FE I LOYED
RELATING TO
FOR INSPECTION
.Pli ck,,wI1dg1dtnsP11-o,111d0d.
rIqLAT N 01 THE LABOR Cool OF THE STATE OF WASHINGTON
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OWNER 0 G N
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771-0220
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EXT/333
ATTENTION
IT IS UNLAWFULTO USE OR OCCUPY ABUILDING OR STRUCTURE UNTIL 771-0221
- INSPECTOR
HAS SEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL FILE YELLOW
GOLD - ASSESEOR
A FINAL INSPECTION
OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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