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DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS , MARQUEES, ETCJ WILL RED IRE
SEPARATE PERMISSION, STATE SURCHARGE
PER IT APPLICATION: ISO DAYS
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
PPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEJFS� ASSIGNS AND SUCCESORS ENG, INSPECTION FEE
IN NTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAP NG
2 EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENT S FROM ANY AND INSPECTION FEE
A LCLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY
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IHEREB ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE OUIY AUTHORIZED AGENT OF
T EOWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSI RUC- CALL . 'pp""o' " "' t VIIIII �la b,
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TION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED -S 11 hWhIl )1p,IV, 1�d F — �
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING To FOR INSPECTION lpt 11 1--ild9od ll,p... p,,,,dld,
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27 111 SIGN DATE
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771-0220 RELEASED By f ATE
ATTENTION EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. LED SECTION 109 FAX PINK - OWNER - GOLD - ASSESSOR
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FINAL PROJ9CT APPROVAJ,-FORM
TO:
DATE:
MEMO TO: PERNUT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
ENGINEERING DIVISION DATE-,6�kL//�) I
PLANNING DIVISION DATE--
PROJEC
SITE ADDRESS- MAIL
PERNUT —ADBk_DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED--,->��...
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
Final approval of the described work
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .. ...................
FOUNDATION:
Footing ...................
wall ...........
Pier/Porch ............
Retaining Wall ...........
Stab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
--Commarclod Final
HEATING:.
a 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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