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ENG� REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG, INSPECTION FEE
'APPLICANT. ON DENALI OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
I I . INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
N NTEAEST, AGREES T
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TOTAL AMOUNT DUE
I HERE BY ACKNOWL EGG E THAT I HAVE READ THI S APPLICATION. THAT THE INFORMATION
CORRECT. AND THAT I AM THE OWNER RATTEHEOUSLI�AUT"OTRINI.IDA.E�T.1
YA " LAW E.U, �ONSTRUC-
THIVElOWNE 'TH C IT N60
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771-0220
717ENTION
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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 08 A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE—
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DIVISION DATE-3 0_—�
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SITE ADDRE
PERMIT #CV4L-_4�*
�ADB# DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PER RMAN
vCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy ofCONDMONS given to owner/contractor by inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES or by inspector
D Copy ofcORRECTION NOTICE given to owner/contract
1.
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date. Sign_
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SETBACKS .....................
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wall ..........................
PledPorch .................
Retaining Wall ...........
0
Stab Insulation ..........
PLUMBING:
underground .............
Rough -in ............
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commercial Final
HEATING:
lin
Gas Test ....................
Gas piping ..........
10
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Equipment .............. q
Commercial Final
M 1711
EXTERIOR SHEATHING
NAILING ..........................
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FIRST FLOOR FRAMING z
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Floor Insulation
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Calling Insulation
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FINAL APPROVAL FOR -0
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01601 06/44 /
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ATE RECEIVED —
PERMIT EXPIRES
CITY OF EDMONDS
ZONE
PERMIT
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CONSTRUCTION PERMIT APPLICATION
JOB
ADDRESS
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REMARKS
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l"G REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
F HI OR HER SP USE. HCISS. ASSIGNS AND SUCCESORS
ON BEHAL 0 S 0
ENG. INSPECTION FEE
;APPLICANT
N INTEREST AGREES TO I.DEMNIl. DEFEND AND HOLD HARMLESS THE CITY OF
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E
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T TALA.OUNT DUE
jvF!5
I HEREBY ACKNOWLEDGE THAT E FEA.THIS APPLICATION: THAT THE INFORMATION
�IIPPLICATIONAPPJROVAL
:H T F
GIVEN IS CORRECT. AND TH41 AM THE OWNER OR THE DULY AUTHOIIIED AGENT OF
IIa,.I.,a—IunIlI.it;nsdbyln.
THE OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING COIiSTRUC
PLOY ED
C A LL
Eu,,TnPP,.
ding or��d, Warne, DNpty: and Fee. are vatd. and
RE W LL BE E
WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
TION. AND IN MIND THE I 'ET
INV[ LpMareQF THE LABOR S. NOT.. RELATING TO
0 CODE OF THE STATE OF WASHINGTON
p 'a ipt: -k...
fF.l� IN ECTION
S
WOAKKfN S C#NENStTIDN INSURANCE AND ACW 18.27,
]
OF IALS SIGNATURE
SIGI4AT=."
ATE
(425)
771-022 0
OAT
—)d-TEATION
RELE�Sey
EXT 1333
ITI� UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
A FJJ�AL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
L
ORIGINAL - FILE' - YEL& - lNiPECTOR
CATEOF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
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