20020029.pdff
[PERMITEXPIRES
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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OWNER NAME/NAME OF BUSINESS
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OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAIN-E
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REMARKS
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VALUATION
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BUILDING 57, l:jI0-7
DATE P-NI.W. f3o-
PLAN CHECK NOO I_ tj /I
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MECHANICAL bo
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVER WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON T E PUBLIC
DOMAIN ICURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILLN REQUIRE GRADtNG)FILL
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLIGAII.N: HISDAYS
PERMIT LIM T. I YEAR - PROVIDED WORK IS STARTED WITHIN 180DWYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION I�REVEW FEES
PPLICANT. ON BEHALF P HIS OR HER SPQUSE� HEIRS, ASSIGNS AND SUCCESORS INSPECTION FEE
IN NTEREST, AGREES TO INDEMNIFY, DEPEND AND HOLD HARMLESS HE CITY 01
EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES� AND AGENTS FROM ANY AND
A LOILAIMS FOR DAMAGESOFWHATEVE NATURE, ARISING DIRECTLY OR INDIRECTLY
THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT, NOT BE R
FROM SHALL PLAN CHECK DEPOSIT
Y C , ORDINANC
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUiREMENTOFAN T E 77
0 NOR LIMIT IN ANY WAYTHE CITY'SABILITYTO ENFORCE ANYORDINANCE PROVISION.'
TOTAL AMOUNT DUE J0ECEj;ffj list).
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION -
GIVEN IS CORRECT, AND THAT 111 THE OVIIII, OR THE DULY AUTHORIZED AGENT 01 APPLICATION APPROVAL
T E OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL
TION; AND IN DO NO THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Dl" 1-
IN VIOL ION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATIN. TO FOR INSPECTION
WORKMEN'S COMPENSATION INSURANCE AND HOW 18.27
O"ICIA IUN IIAH
SIGNAT:=Tl DATE SIGNED (425)
771-0220 -11LEAStO fly VAILI
ATfEN-f1ON EXT 1333 1 -/
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL //vk
771-0221 -k
A FINAL INSPECTION HAS BEEN ADE AND APPROVAL OR A CERTIF]. 0 YELLOW INSA CIO'
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CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 IINK NIER GOLD ASSESSOR
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A field inspection was conducted to determine final comp Hance with approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
o Copy of CORRECTION NOTICE given to owner/contractor by inspector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign_
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing .............
Wall ..........................
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Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
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Rough
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Commercial Final
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HEATING:
GasTest ....................
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Gas Piping .................
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Commercial Final
EXTERIOR SHEATHING
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NAILING ................ ..........
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FRAMING .............
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INSULATION ...................
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Ceiling Insulation
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SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..........