20010578.pdfDA11RIC11110
FpERMIT EXPIRES
CITY OF EDMONDS
PERMIT
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CONSTRUCTION PERMIT APPLICATION
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET Al
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NAME
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OWNER/CONTRACTOR BEEP NSfBLE FOR EROSION CONTROUDRAINAGE
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NAME
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ADDRESS
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0 NEW gRE51DINTIAL 0 PLUMBING i MECH
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FRONT IJASIDE REAR
0 ADDITION E] COMMERCIAL [3 COMPLIANCE OR
CHANGE OF USE
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PLANNING REVIEWED 51 DATE
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GRADING C] FENCE
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REMARKS
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VALUATION
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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SEPARATE PERMISSION.
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PERMIT APPLICATION: Too DAYS
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PERMITLIMIT.1 YEAR. PROVIDED WORK IS STARTED WITHIN 180DAYS
EVIEW FEES
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT 'an MORE INFORMATION
E NO INS FE.T'.N FEE
S E SU E
LICANT. ON BEHALPOF HISOR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESOnS
;AP
N INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY 01
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EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM AN' AND
LANDSCAPING
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A _C�IMSFORDAMAGE OVWHATEVER NATURE. ARISING DIRECT, OR I.M.ECTI
RECEIPT
x FA M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
I
0 NOR LIMIT IN ANYWAY THE CITY S AWLITY TO ENFORCE ANY ORDINANCE PROVISION60
CEIPT/
TOTAL AMOUNT DUE
IR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT - THA I AM THE OWNER. OR THE DULY AU HOnIZED AGENT OF
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IN VI6t_ATiO OF HE LABOR CODE OF THE STATE OF WASHINGTON
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FOR INSPECTION
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WORKNIE�N PEINMAT&�ANCE ANDRCW 1827.
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OFPICIA RE DATE
(425)
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771-0220
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1 DYE
Aft—ENTION
EXT 1333
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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-
ORIGINAL FILE YELLO * INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
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MEMO TO: pERmrr COORDINATOR, BUILDING DIVISION
41�17IRE DEPARTMENT DATE
FROM: & —L L
ENGINEERING DIVISION DATE—
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PLANNING DIVISION DATE—
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A field inspection was conducted to determine final compliance with approved plans. Final approval
the signed Department to the release of
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PERFORMANCE BONDS and the granting of:
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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MICROFILM
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_—. Sign_
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RECORD OF INSPECTIONS
SETBACKS .....................
FOUNDATION:
Footing ......................
. .....................
PlartPorch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground ............
Rough -in ...................
Commercial Final
HEATING:
GasTest ....................
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 ..................
ioFPERMIT EXPIRES
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U.E li PERMIT
-CITY 01F EDMONDS
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NUMBER o,5 -7A
CONSTRUCTION PE!LMIT APPLIC ATION
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rl I tA A AI i' 4\
VALUATION
FEE
PLAN CHECK FEE
HEATSOURCE GLAZING I
LOT SLOPE %
PLAN CHECK NO:
rlSTID DATE
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
. BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
L
2 WAY
o DOMAIN (CURBS. SIDEWALKS. DRIVE S, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
GRADINGIFLL
PERMIT APPLICATION: 160DAYS
PERMIT UMITJ YEAR. PROVIDED WORK IS STARTED WITHIN 180 DAYS
E G. REVIEW FEES
SEE BACK OF PINK PERMIT FOR AORE INFORMATION
ENG. INSPECTION FEE
;APPLICANT ON BEHAL OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. ANDAGENTS FROM ANYANO
ALLCLAIMS FOR D�GESOF WHATEVER NATURE.ARtSING DIRECTLYOR INDIRECTLY
ROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT B
TYD
D EMED TOMODlFy. WAIVE OR REDUCE ANY REQUIREMENT OF ANYCI RDIMNC:
E S ABILITYYO ENFORCE ANYORDINANCE PROVISION.'
0 NOR LIMIT IN ANY WAY THE CITY
LANDSCAPING
INSPECTION FEE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
RECEIPT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
T. E .11 ER, I. A.CC CooMP=CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN D RX IZED THEREBY. NO PERSON WILL BE EMP YED
TV i LABOR CODE OF THE WASHINGTON RE ATING TO
MW
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Olp HI
CALL
FOR INSPECTION
APPLICATION APPROVAL.
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OFFICIA S SIG DATE
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771.-0220
EXT 1333
RELEMSEDBY DIfE
AWEENTION
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- ORiGINAL-FILE YELLOW, INSPECTOR
CATE OF OCCUPANCY HAS BEI!N GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
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