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PERMIT EXPIRES
CITY OF EDMONDS
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0 REMODEL 0 APARTMENT 0 SIGN
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( X FT)
REMARKS
DEMOLISH 0 TANK o OTHER
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DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REQ'I
VALUATION FEE
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MIT .V.E$ Wo. KT.
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS BE MIT COVERS WORKTO
BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC;
DOMAIN (CURBS, SIDEWALKS, DRIVE a , T. I WILL -E.URE
WPEARS!' MAR U ES, ETC.) WILL REQUIRE
GRADINGIFILL
SEPARATE IssioN.
__UFI`-A-GE
TPLANCHECKDEPOSH
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT�. I YEAR , PROVIDED WORK IS STARTED WITHIN i8D DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MDRE INFORMATION
N AN E
S S
AP PLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND $UCCESORS
FE
ENG. INSPECTION FEE
-MLF�S 'HE CITY OF
IN NTER5ST. AGREES TO :NDEMNIFY. DEFEND AND HOLD HARMLESS TH' CITY OF
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2 EDMONDS, WASHINGTON, TS OFFICIALS, EMPLOYEES, AND AGENTS FR ANYAND
INSPECTICIN
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECT�YO R INDIRECTLY
-1 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
2�
DEEMEDTOMODIFY, WAIVEOR REDUCE ANY REQUIREMENTOF ANY11 C
CITY ORDINANC
PL CHED E POSH
JRECIIPT
NORL-TiN ANYWAYTHE CITY'SABILITYTO ENFORCE ANY ORDINANCE PROVISION.
RED
TOTAL AMOUNT DUE
I
]HERBS ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION� THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
T EOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CON$TRUC-
CALL
T11. appl-l- 0.1- il b,
TION,AND,IND ING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN W LAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
-B Olk-:'I" ffill DIP.1y: Ild F111 110 pld.
FOR INSPECTION oco,pt sp... p
WORKMEN S COMPENSATION INSURANCE AND RCW 18.27,
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RELEASED By DATLI
ATTEdTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD . ASSESSOR
519.
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall .............
Pier/Porch .................
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Retaining Wall ..........
Slab Insulation ..........
0
PLUMBING:
Underground .............
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Rough -In .............
C
0
Commercial Final
0
C
HEATING:
C
IT!
A
Gas Test ....................
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C
Gas Piping .................
> -i
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Equipment
.............
0
Commercial Final
TIM
-4
EXTERIOR SHEATHING
1711 ITI
NAILING ..........................
0 ra
0
0
FRAMING ........................
C
M ca
FIRST FLOOR FRAMING
M 0
INSULATION ...................
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Fiber Insulation
Wall Insulation ...........
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Calling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
94 91