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PERMIT EXPIRE S=
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STATE SURCHARGE
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PERMIT APPUCATI N: IBM DAYS
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ENG, REVIEW
END INSPECTION FEE
ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS ANDSUCCESORS
;APPLICANT
N INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE C17Y OF
LANDSCAPIN
2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANYAND
A LCLAIMS FOR DAMAGESOFWHATEVER NATURE. ARISING DIRECT RECTLY
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PERMIT. ISSUANCE OF THIS SHALL NOT BE
INSPECTION FEE
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FROM THE ISSUANCE OF THIS FPERMIT
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT 0 ANY CITY ORDINANCE
ANY ORDINANCE PROVISIONm�
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HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
APPLICATION
APPROVAL
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WITH CITY AND STATE LAWS REGULATING CDNSTRUC
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IN VIoLAT ION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELAT NO TO
FOR INSPECTION .—.d,
WOFXMENjW'fflhN�NSATION INSURANCE AND RCW 18.27.
o,(161ALS SIGNATURE DIE
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(425)
139-1 i" I/&,
Qe-23-01
771-0220
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DATE
AttENTION
EXT 1333
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 - YELLOWIMSPEC�011
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
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1990 EXISTIN6, DETACHED GARA(9E: 1112 S.F. (rONSTRXTED IN lqql) qq.0' + q5.4'- qb.-7)/4 = ql-I'
POSED ADDITION: 56 S.F. MA �C
36/ So' Aooerb pwue�TITAL BUILDINS, IMPERVIOUS AREA: 3036 S.F.
lq97 -ERipF-Q6E9 BIJILON6 HE*HT = '111 . 25 - 122.1
EX15TIW, DRIVEYiAY: 5625 S.F.
DATUM P01NT PROPOSED AALK; 62 5F. EXI5TIN6/PROPO5EP BUILVIN6, HEIr7HT - 110.2'
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TOTAL IMPERVIOUS AREA: 6`155 S.F.
HATER METER
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APPROVED i3y PLANNING
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CITY COPY
LOT AREA: IDPW S.F.
TOTAL LOT COVERA&E bq-15 5FADPOO 36h%
. . FiNAL PROJECT APPROVAL FORM
TO:-
DATE: —
MEMO TO: PERMIT COORDINATOI?, BUILDING DIVISION
FROM: FIRE DEPARTNIENT DATE —
ENGINEERING DIVISION DATE 0. 102-
PLANNING DIVISION DATE—
PROJECT —
SITE ADDRESS
p ERMIT #A ADB#------DATF INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED —
Final a roval
A field inspection wRs conducted to determine final compliance with approved plans. PP
denotes that there are no objections from the above signed Department to the release of
PE )RMANCE BONDS and the granting of:
--�-GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 copy ofCONDMONS given to owner/contractorby inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
(3 Copy of CORRECTION NOTICE given to owner/contractor by inspector
1.
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date-- Sign_
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SETBACKS .....................
FOUNDATION:
Fooll...... ... .......
Wall LQ1 OA
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
Gas Test ....................
Gas Piping ................ L
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
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FRAMING ........................ AO*
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation cv�
Wall Insulation 0
Calling Insulation
SHEMOCK NAILING 3
SPECIAL INSPECTION 661 L4 A41 6"*
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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WORKMEN S,@eM4INSATION INSURANCE ANDRCW 18 27
01 6 SIGNATURE DATE
I
DATE SIG ED
(425)
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771-0220
H By I DATE
EXT 1333
AfflENTION
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 YE)LL -,NSPECTOR
CATE OF P NCY HAS BEEN GRANTED. USC SECTION 109
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