20010819.pdfr =
DATE RECEIVED PERMIT EXPIRES
USE PERMIT
CITY OF EDMONDS ZONE N"M.ER
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTE.�61NTS LLREOUtRE
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I HEREBY ACKNOWLE DD E THAT I HAVTE READ THIS APPLICATION. THAI THE INFORMATION APPLICATION APPROVAL
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GIVEN IS CORRECT, AND THATIAM HEOWNER.ORTHLAW EGULAIINGCIDNSTRU� CALL D"'P,':
THE OWNER I AGREE TO COMPLY WITH CITY AND STATE A,,.wI.d9.1 p pl—ftd,
,"ER,BY610 PERSON WILL BE EMPLOYTED
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IN V,. All IN "DING T OF
OL.I.N .1 THE LABOR CODE OF TH
WORKMEN I COMPENSATION INS * URANCE AND RCW IS 27 DATE SIGNED (425)
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'01-2,101 771-0220 ELE D
ATTENTION EXT 1333 o
IT IS UNLAWFUL TO USE OR OCC LDING OR STRUCTURE UNTIL 771-0221 ORI INAIL. FILE Y&LOW INSPECTOR
Upy A SU GOLD ASSESSOR
A FINAL INSPECTION HAS BEEN ADE AND APPROVAL OR A CERTIF1 FAX PINK OWNER
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
,IS
FINAL PROJECT APPROVAL FO
TO:-
DATE: —
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATE—LLL—_�- ___c"
ENGINEERING DIVISION DATE-_
PLANNING DIVISION DATE—
PROJEC
SITE ADDREs
PERMIT # 0 AD]3#__________PATE INSPECTED_LL—/ L— —0/
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
PERFORMANCE BONDS and the granting of:
><- GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WrM CONDITIONS NOTED
a Copy ofCONDITIONS given to owner/contractor by inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTTCE given to owner/contractor by inspector
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2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ..................
Commercial Final
HEATING:
Gas Test .................
-Gas Piping .................
Equipment ............
Commercial Final
E)ITERIOR SHEATHING
NAILING ..................
FRAMING........................
FIRST FLOOR FRAMING
INSULATION ...................
Floorinsulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ...............
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THIS PERMIT AUTHORIZES ONLY�HE WORK NOTED. THIS PERMIT COVERS WORK TO
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STATE SURCHARGE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
EQQ� RE EW F�E Z��
PERMIT LIMIT: I YEAR - PROVnD D WORK IS STARTED WITHIN 100 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'A PLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND IUCCESORS
7;7�
LANDSCAP No
IN NTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
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EDMONDS. WA HINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALLCLAIMS FOR DAMAGESOFWHATEVERNATURE, ARISING DIRECTLY ORIN IRECTLY
INSPECTION FEE
PLAN CHECK DEPOSIT
x
FROM THE ISSUANCE OF T IS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMEDT MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANYCITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
TOTAL AMOUNT DUE
I HERESY ACKNOW EDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
T EOWNER. I AGREE TO COMPLY WITH CITY No STATE LAWS REGULATING CONSTRUC.
CA;L
TION AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE E-P DYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
EAP R INSPECTII
WORKMEN I COMPENSATION INSURANCE AND RCW 182T
SIG 7fi';�XZ —T.ATE.�.NE.
(425)
771-0220
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTiFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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