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STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
WORK IMS STARTED WITHIN 130 DAYS
S
ENO REVIEW FEES
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Retaining Wail ...........
Slab Insulation
PLUMBING:
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Rough -In ...................
Commercial Final
HEATIN
Gas Test ....................
Gas Piping ................
Equipment ...............
9 -120-
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EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
Wall Insulatlon ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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THIS PERMIT AUTNOR!711� .14LI THE �0111( NOTED. THIS PERMIT COVERS WORK TO
0 PUBLIC
DE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
OMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
GAIDING"ILL
SEPARATE PERMISSION. —
STATE SURCHARGE
PERMITAPPLICATI N laooAys
PERMIT LIMIT'. I YEAR - PROVIDED WORK IS STARTED WITHIN 180DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG, REVIEW�FEES
PLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
�A
N INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
a EDMONDS WASHINGTON ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANYAID
01 WHATEVER NATURE. API 0 11— 11 _... -1
ALICLAW�FOIIDAMA��ii D,
NSPECTION FEE
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P AN CHECK DEPOSIT
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. .
TOTAL AMOUNT DUE
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tHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
—
APPLICATION APPROVAL
GIVEN IS CORRECT. AID THAT I AV THE OWNER, OR THE DULY AUTHOIIIED AGENT OF
CONSTRUC-
'N�
THIOWNER. I AGREE TOCOMILY WITH CITY AND STATE LAWS REGULATING
THEREBY, NO PERSON WILL BE EMPLOYED
CALL
TION. AND IN DOING THE WORK AUTHORIZE.
IN VJOILATION OF THE LABOR Coo E OF THE STATE OF WASHINGTON RE LATNG TO
FOR INSPECTION
P.. d
WORKMEN S COMPENSATION IN SURANG ANDACWi827,
OFFI ON U DYE
0 ENT) D
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FAX
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