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RMIT EXPIRES
OF EDMONDS
PERMIT
NUMBER
CITY
C. JOB
CONSTRUCTION PERMIT APPLI ADDRESS
SU
OWNER NAMEINAMEOr SU91HEISS 2000 /J_c_
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on� A, SIGNS AND SUCCESORS
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ANY ORDINANCE PROVIS ON
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TOTAL AMOUNT DUE
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APF LICATION APPROVAL
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FOR I NSPECTION
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AND RCW 6.27
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WORKMEN
FFI S SIGN I E DATE
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D Nw.
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(425)
SIGNATUr)�M,��ENTI(7'�:A�TE
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771-022Q
ASED By DATE
EXIA 333
ATT0NfION/'-,,
IT IS UNLAWFUL TbIVS� OR OCCUPY A BUILDIISIG�ll STRUCTAREEUNTIL 77- f-0221
L 0, C
A FINAL INSPECTION H4S BEEN MADE AND APPROVA RTFI
FAX
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CATE OF OCCUPANCY H�S BEEN GRANT C SECTION 109
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FIN' '71' PROJECT APPROVAL QRM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATE
(L-6 -SL—ENGINEERING DIVISION DATE
PLANNING DIVISION DATE—
PROJEC
SITE ADDRESS P)
PERA11T #_,Q��ADB#_________DATE INSPECTED 0
DESCRIPTION OF WORK TO BE INSPECTED
I approval
A field inspection was conducted to determine final compliance with approved plans. Fina
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of -
_J,��GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
o Copy of CONDITIONS given to owner/contractor by inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
o Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign_
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
wall.........................
Pier/Parch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
commercial Final
HEATING:
Gas Test
pas Piping
Equipment.................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING--o .....................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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PROPOSED SETBACKS (FT.)
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COMPLIANC OR
0 ADDITION COMMERCIAL 0 CHANGE OF USE
PARKING
LOT AREA LANNING REVIEWED DATE
0 REMODEL APARTMENT 0 SIGN
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PLAN CHECK FEE
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PLAN CHECK NO:
r ESTED DATE
MECHANICAL
TH' M UTHORIZES ONLY THEWORK NOTED. THIS PERMIT COVERS WORK TO
1IR 'AUTHo'aEI RUCTIONONTHEPUULIO
3P D 'T
SIM D ON PRIVATE PROPERTY ONLY. ANY CoNST ETC.) WILL REQUIRE
MARQUEES.
GRNDLNG11ILL
(CURBS, SIDEWALKS, DRIVEWAYS.
G N CURBS ' BIG
,
A' SEPARATE PERMISSION.
-T�TE SURCHARGE
PERMITAPPUCAT
P
PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WI HIN 180 DAYS
IT LIMIT ' 'EA
F
E REVIEW FEES
NO
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
SEE SAC K I
ENG. INSPECTION FEE
'APPLICANT. ON DENALI OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
T o BE. LF
NO AN HOLD AR L SS THE
IN INTEREST. AOR111 TO N.E.N,.� E D H m E CITY OF
. I
:Tr
LANDSCAPING
�GEI
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DMO N LS. EMPLOYEES. AND AGENTS FROM
GS,WASH'NOT...
�TNS _IFS
INSPECTION FEE
RISING D
OA E. FWHA EVERNA A IRECTLYORINDtHECTLY
A LA o WG S o T TURE.
ALL NOT B E
E PERM
THI RMIT ESUANC OF THIS
E oM THE M SU Y IN o Sp oU E R ANYIT SH ORDINA CE
FR ANCE E C Y R oUI EMENToF CITY
oTo o V
11 D EME DIF Al EOR E EAN
PLAN CHECK DEPOSIT
NORL YW Y TH CITY� SILITY To E FORCEANYoSDINANCEPRovIsION.-
01 jiyiR IN AN E S A N
TOTAL AMOUNT DUE
A
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIO"; THAT THE INFORM TION
AGENT OF
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED
AND STATE LAWS REGULATING CONSTRUC
CALL
TH EDWNER. I AGREE TO COMPLY WITH CITY
TION. AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
RE ATING TO
FOR INSPECTI(
IN VIOILATI N BoR CODE OF THE STATE OF WASHINGTON
GFIKMEN`Sq;��TAIDN INSU�� ANDACW 1827.
SIGNED 1�w.
(425)
��TE
is. Ivo I
771-02-2y.
E*T -1333
ATTONTIONC /.
rCUPYA E UNTIL
IT IS UNLAWFUL T ORO, BUILDING STRUCTUR 771-0221
'V�
�
'R
A FINAL INSPECTION Hi�S=MADr AND A ROVALORACERTIFI-
C.
GRANTED. BC SECTION 109
CATE OF OCCUPANCY 1- B ,
FAX
FEE
kPPLICATION APPROVAL
ORIGINAL.FlLE YELLOW -INSPECTOR
PINK - OWNER GOLD - ASSESSOR
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CONSTRUCTION PERMIT APPLICATION
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CITY ZIP I TLOCEPHOk
u I I PERMIT EXPIRES �, �lSyl
USE I)-,,! PERMIT Qf io
ZONE NUMBER 0
JOB '7 S
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PLAT NAMEISUBDIVISION NO, LOT NO. Ull NO.
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I S 0 NO 0
EMARKS
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CITY ZIP
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ENGINEERING
REVIEWEDIDATE
A DRESS
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DATE
CITY zi,
qf).4u
r;;6�
STATE LICENSE NUMBER - EXPIRATION DATE
e 4( 9 q_ IT
A&- 3 4" 1" -3
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INSPECTION
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B DO
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or
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up
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(
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LOTCOVERAGE
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PROPOSED SETBACKS (Fr.)
FRONT 'jjA SIDE REAR
j
PARKING
REGO I PROVIDED
LOT Al
PLA, NNlNG RENTEWED BY DATE
EN
r (TYPE OF USE, BUSINESS OR ACISj"I�L
CHECKEDBY
ITYPE:MN
I
OCCUPANT
GROUP
b, NUMBER
OF
STORIES
NUMBER o
DWELLING
UNITS
CR ITII AL
AR S
NUMBER �L�
-.I.CIALE�.N.P�CIO� JAREA
R ." R
El YES
I OCCUPANT
LOAD
DESCR18E WORK TO BE DONE
-
REMARKS
PROGRESS INSPECTIONS PER USC 1OWFINAL INSPECTION REQ'O
f�
j J, 4xe J I
-'s
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE GLAZING % LOT SLOPE %
I I %
BUILDING
PLAN CHECK NO: 111STED DATE
PLUMBING
THIS PERMIT AUTHO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
H
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON T EPUSUC
GRADINGIPILL
U
DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS. MARQUEES. ETC.) WILL RED IRE
SEPARATE P RMISSION.
STATE SURCHARGE
PERMiTAPPLtCATiON: ISO DAYS
PERMIT LIM I. I YEAR - PROVIDED WORK IS STARTED Vill HIN 180 DAYS
ENG REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE IN ORMATION
"A""ANI F HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
ENO, INSPECTION FEE
IN INTERES�T.A.ZE"E'SLT INDE.NIl. DEFEND AND HOLD HARMLESS THE CITY OF
S
S
LANDSCAPING
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
- ALLCLAIMS FOR DAMAGESOFWHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY
INSPECTION FE E
RECEIPT
m FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
o ..E.E. 1. 1 WAIVE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
I
0 NOR LIMIT IN ANY WAY THE CITY S ABILITY TO ENFORCE ANYORDINANCE PROVISION"
CT�&
�j
TOTAL AMOUNT DUE
IA
I HERE BY ACKNOW'E DO E THAT I HAVE READ TH IS APPLICATION, THAT THE IN FORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND T AT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TOCOMPLYWITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
1-t IrIl.t $lglld by III
TION. AND MOOING 7HEWORK AUTHORIZED THEREBY. NOPERSON WILLBE EMPLOYED
It , b, - F ... ... P-.-
IN VIOLATION R CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
-pI.I11011Ildg,d-F - w pl-d-
WORKMEN I IN INSU��;E AND RCW IS 27
(425)
OFFI S SIGNATLOE /j/bT!_/
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771-0220
f & f
;L' �ASED-S—y
DATE
777N-TioN
EXT 1333
C C LIMP 'UL' URE UNTIL
IT IS UNLAWFUL T IN' R s .. cT
��Rj
Aj
771-0221
1
30
EEN A D A OAL "
A FINAL INSPE E AN' A CERTIFI-
C
ORIGINAL -FILE YELLOW INSPECTOR
,c SECTION
CATE OF OCCUPANCY H)��El GRANTED. 09
FAX
PINK - OWNER GOLD ASSESSOR
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RECORD OF INSPECTIONS
'44
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATIION:
Footing ......................
wall..........................
Pier/Parch .................
Retaining Wall 7—
Stab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING*
GasTest ....................
Gas Piping .................
Equipment..............
Commercial Final
E)(TERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Calling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
.10) �
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