20010771.pdfCITY OF EDIVIONDS
CONSTRUCTION PERMIT APPLICATION
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THIS PERMIT AUTHOR Z'S ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
It BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADING"ILL
2 W
DOMAIN (CURBS. SIDEWALKS, DRIVE AVS, MARQUEES. ETQ) WILL REQUIRE
SEPARATE PERMISSION.
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PERMIT APPLICATION: 180 DAYS
P. PERMITLIMIT.1 YEAR -PROVIDED WORK IS STARTED WITHIN 18GDAYS
END REVIEW FEES
SCCBACKOF PINK PERMIT FOR MORE INFORMATION
ENG INSPECTION FEE
ON BEHALF OF HIES OR HER SPOUSE HEIRS. ASSIGNS AND SUCCESORS
;APPLICANT.
N NTEREST�AGREES TO IND NI1Y. DEFEND AND HOLD HARMLESS THE CITY OF
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EDMONDS. WASHINGTON. ITS OIFICIALS, EMPLOYEES ANDAGENTS-M ANYANO
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ALLCLIIMSFOR DAMAGES OF WHATEVER NATURE. A DIRE
INSPECIION FEE
RECEIPT
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
BE EMEDTD MODIFY. WAIVE OR REDUCEANY REQUIREMENTOF ANY CITY ORDINANCE -
PROVISION
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TOTAL AMOUNT DUE
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT 01
T A'P"P. . '.-I " P'_
THEO'NEA I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING COINSTRUC
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IN PECTION HAS BEEN MADE AND APPROIAL OR A CERTIFI-
ORIGINAL -FILE - YCILOW-INSPCCTOR
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T'E LIF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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CONSTRUCTION PERMIT APPLICATION IOB SUITEIAPT,
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REMARKS
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VALUATION
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BUILDING
PLAN CHECK NO: IVESTED DATE APLUMBING
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
ISEDONFO PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUB`I�C
DjjjyMAyR%SSION � ETCJ WILL REQUIRE�
DOMAIN (CI)RDS.Si!)EWALKS -MAR BUSES
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ENG REVIEW FEES
SEE BACK O� PIRNOVIIDERMIT FOR MORE INFORMATION
ENG. INSPECTION FEE
'APPLICANT, ON BEHALF OF HIS 08 HER SPOUSE. HEIRS, ASSIGNS AND SUCCSSORS
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY Or
AND C FIND
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2 E NIONOS.W.S.INOTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANYAND
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ILNSPECTAI.N FEE
ALL CLAIMSFORDMAAGESOF�TEVER NATURE. ARISING DIRECTLYOR -- --
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAIN CHECK DEPOSIT
RECEIPT
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENTOF AN' CITY ORDINANCE
NOR LIMIT IN ANYWAY THE CITY*S ABILITY TO ENFORCE ANY ORDINANCE PROVISION'
TOTAL T DUE
7
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INEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN I CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHOR ED AGENT OF
CONSTRUC-
rAMOUNT
THE OWS ER I AGREE TO COMPLYWITH Cl Y AND STATE LAWS REGULATING
BE EMPLOYED
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CALL
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ATTENTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
A FIN SPECTION HAS BEEN MADE AND APPROVAL OR A CESTIFI_
ORIGINAL FILE YELLOW INSPECTOR
CLIPANCY HAS BEEN GRANTED. UBC SECTION log
FAX
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