20000999.pdfDATE RECEIVED [PERMIT EXPIR_
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USE PERMIT
CITY OF EDMONDS 'ONE A 'S NUMBER 200999
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ON N T UCTION ON THE PUBLIC
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ON PRIVATE
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SEPARATE pen ON.
SURCHARGE
PERMIT APPLICATION: ISDDAYS
ENG. REVIEW FEES
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS
SEE BACK OF PINK PERMIT FDA MORE INFORMATION
ENG. INSPECTION FEE
RUSSIGNS AND SU CESORS
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DEEMEOT MODIFYWA"EOR EDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
I NOR LIMIT IN ANY U ABILITY To ENFORCE ANY ORDINANCE PROVISION.
W�YTHUCITY�
TOTAL AMOUNT DUE
I HE REBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
THE DULY AUTHORIZED AGENT OF
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR
THU OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSIRUC
CALL
P ON WILL BE EMPLOYED
TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO 'RSNGTON RELATING TO
WASHI
FOR INSPECTIl
IN VIOLATION OF THE LABOR CODE OF THE STATE OF
5.0�kNS COMPENSATION INSURANCE ANDRCW 18.27.
SIGNATU e ED
(425)
771-0220
EXT 333
ATIWNT16N
IT irUNLAWFULTO 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. LIBC SECTION 109
FAX
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SETBACKS .....................
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Wall ..........................
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Retainlrig Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final 7
HEATING:
-5
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
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FINAL APPROVAL FOR
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
PUBLIC
BE .. E ON A'WkTE PROPERTY ONLY. ANY CONSTRUCTION ON THE
ETC.) WILL REQUIRE
GRADINGIFILL
�S. AYS, MARQUEES.
DOMAIN (CURB SIDEWALKS, DRIVEW
SEPARATE PERMISSION.
SURCHARGE
PE MIT APPLICATI Ni ISO DAYS
PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
;A PLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. A SSIGNS AND SUCCESORS
DEFEND AND HOLD HARMLESS THE CITY OF
ENO, INSPECTION FEE
LANDSCAPING
NPNTEREST. AGREES To �NDEMNIFY.
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2 EDMONDS. WASHINGTON, TS OFFICIALS. EMPLOYEES, AND AGENTS FRO. ANYAND
INSPECTION FEE
1. A CLAIMS FOR DAMAGES OFWHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
BE
AEC PT
I FLLOM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT
PLAN CHECK DEPOSIT
DEEMEOTO MODIFY. WAIVE OR REDUCEANY REQUIREMENTOF ANY CITY ORDINANCE
'S ANYORDINANCE PROVISION *
__
RECEIPT
uo
0 NOR LIMIT IN ANYWAYTHECITY ABILITY TO ENFORCE
TOTAL AMOUNTDUE
I HEREBY ACKNOWLEDGE THAT; HAVE READ THIS APPLICATION; THATTHE INFORMATION
APPLICATION App 0
GIVEN IS CORRE CT, AND THAT A. THE OWNER. OR THE DtJLY AUTHORIZED AGENT OF -
0 WITH CITY AND STATE LIMS REGULATING CONSTRUC
MPLY
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T PF11-11— 11 1 1 P—I "'�Zy
CALL B,d,, offi,iml .1 hIS11,11 Dlputy
THE OWNER. I AGREE T OC
TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE LEMPLOYED.
I T
RE AT NG
FOR INSPECTIOI q ......
W
IN VIOLATION OF THE LABOR CODE OF THE STATE OF ASHINGTON
PENSATION IN,
VpRWAkN S COM INSURANCE AND RCW 18.27�
OFF191 S SIGN RE OAT
SIGNATU E (OWNER E
ED
(425)
771-0220 RELEASED BY DATE
EXT 33
JiNn&
IT I�IUNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL FILE - YELLOW - INSPECTOR
A FINAL.
BEEN GRANTED. JBC SECTION 109
FAX PINK -OWNER - GOLD - ASSESSOR
CATE OF OCCUPANCY HAS
5198