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CITY OF EDMONDS
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INK PERMIT FOR MORE INFORMATION
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ENG. INSPECTION FEE
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771-0220
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ATTENTION
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HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR
A FINAL INSPECTION FAX PINK. OWNER GOLD -ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wall ...........
Slab insulation ..........
PLUMBING:
Underground .............
Rough-tn ...................
Commercial Final
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial, Final
EXTERIOR SHEATHING
NAILING..........................
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FRAMING ........................
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FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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C?DATER101111D
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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STATE LICENSE NUMBER EXPIRATION DATE CHIC""'
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PROPERTY TAX ACCOUNT PARCEL NO.
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VESTED DATE
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THIS PERMIT ALIT ... UES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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PERMIT LIMIT. I YE AR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
E mc�. REVIEW FEES
SEC SAC K OF PI�K PERMIT FOR MORE INFORMATION
APPLI ANT, ON BEHALF HIS OR HERSPOUSE. HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
NdEMN FY. DEFEND AND HOLD HARMLESS THE CITY OF
IN I TEREST. AGREES TO I IF
L�ANpl�SCCTA, "�TGF
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EDMONDS,WA$HINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISIN
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RECEIPT
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FR M THE ISSUANCE OF THIS PE RMR` ISSUANCE OF S PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
0
EMEDTOMOD FYWAIVE OR REDUCE NY RECUIREMENt OF ANY CITY ORDINANC
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ENFORCE ANY ORDINANCE PROVISION.'
HLIE I I T/63
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NOR LIMIT IN —'WAY THE CITY S ABILITY TO
TOTAL AMOUNT DUE
1? 5,
1
I HEREBY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION, THAT THE INFO NATION
APPLICATION
APPROVAL
46
GIVEN IS CORRECT. AND THAT A. THE OWNER. OR THE DU--Y AUTHORIZED AGENT Or
T—1-1-01 ----
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
CALL
6.11-2 OH,,..l 111,—, DIPUtY. ald F— .11 Pl.d. Ild
TION: AND IN DOING THE W ORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPL.YTED
RELATING 0
FOR INSPECTION
--M.,fpd 1� p.. p,o,d.d
IN VIOLATION OF THE LA BOR CODE OF THE STATE OF WAtHl NGTON
WORKM EN S COM PENSAT��UFANC E AND RCW 18 �2
ALS SIGNATURE DATE
SIGNED
(425)
Z'wo
60,Ak'a
771 -0220
D— I
, Sy
ENTION'
EXT1333
7),s
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221-,
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A C ERTIFI-
ORIGINAL FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTEE). UBC SECTION 109
FAX
PINK - OWNER GOLD - ASSESSOR
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