20020036.pdfCITY
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CONSTRUCTION PERMIT APPLICATION
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PLAT NAMEISUBDIVISION NO.
LOT NO.
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REMARKS
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
NAME
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STATE UCENSE NUMBER EXPIRATION DATE
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REMARKS
DEMOLISH TANK OTHER
GARAGE RETAINING WALL
CARPORT ROCKERY RENEWAL
UWE OF USE, BUSINESS OR ACTWTM EXPLAIN:
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VALUATION $
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Description
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Building
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ESTED DATE
PLAN CHIECK,7,
Plumbing
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
BE DONE ON PRIVATE PP.CrERIV ONLY. ANY CONSTRUCTION ON THE PUBLIC
LLR
3 DOMAIN (CURES, SIDEWALKS, DRIVEWAYS, MARQUEES, Il WI EQUIRE
Grading
Recording Fee
tc SEPARATE PERMISSION.
2
5 PERMITAPPLICATi
Engr. Review
N: INDAYS
PERMIT LINIM I YEAR - PROVIDED WORK 15 UA�D WITHIN IN DAYS
Engr. Inspection
_�I�ty�urcharge
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON OE-11 01 HIS OR HER SPOUSE, HEIRS, ASSIGN. AND UC.E....
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
Traffic Mitigation
Plan Chk Deposit
EDMONDS, WASHINGTON. ITS OFFICIALS, "'PLOY"'. AND AGENTS FROM AN' AN.
ALL CLAIMS OF
Fire Review
Receipt #
FOR DAMAGES WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF TH S PERMIT ISSUANCE OF THIS PERMIT SHALL NOT E
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DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT F MY ITYOADINANCE
Fir einspection
Total Amount Due
o NOR LIMIT IN ANY WAY THE CTYa ABIUTY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapainsp.
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE OULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
TION;
CALL
This applardon Ishas a perolsoni,ighN by lb.
AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATI
Building Official or Walser Depay: and red$ am paid. and
WORKMENO COMPENSATION INSURANCE AND RCW 18.27. N RELATING TO
a N OF THE LABOR CODE OF THE STATE OF WASHINGTO
FOR INSPECTION
on inpu I, ank ... IdN,d h—pano p—lded,
DATE SIGNED
(425)
1 NATURE DATE
2— L) If
771-0220
ATTENTION
EXT 1333
REL Y DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
FAX
ORIGINAL � FILE YELLOW - INSPECTOR
PINK - OWNER GOLD - ASSESSOR
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FINAL PROJECT APPROVAL FORM
TO:-
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE -
ENGINEERING DIVISION DATE -
PLANNING DIVISION DA7 I'E
PROJECT�--
SITE ADDRESS- 15-ru Patel' f-1,
PERMIT 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
PERFO I CE and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
c3 Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u 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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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATE —
ENGINEERING DIVISION DATE—
_.L�PLANNING DIVISION DATE
PROJECT ro L - L 4 1) E r— - " S 9 - S ---
SITE ADDRESS
PERmrr#-:Z- ADB#_______---DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED____f� �IGIA
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 WITH CONDITIONS NOTED
a Copy ofCONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
1.
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 ....................
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Pier/Porch
Retaining Wall ...........
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Slab Insulation ..........
PLUMBING:
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Underground .............
M 0
0
Rough -in ...................
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Commercial Final
3: ITI
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HEATING:
Gas Test ..........
Gas Piping ...... . .........
0 _n
Equipment .................
M 1711
Commercial Final
Fit
0
EXTERIOR SHEATHING
NAILING ..� .......................
0
C co
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ITI 0
FRAMING .....................
FIRST FLOOR FRAMING
INSULATION ...................
z
Floor Insulation
Wall Insulation ...........
z
Ceiling Insulation
SHEETROCK NAILING
0
IT
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY