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PERMIT EXPIRES
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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VALUATION $
DescrIpIllon
FEE
Description
FEE
Plan Check
HEAT SOURCE GLAZING % LOT SLOPE III,
Building
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORMES ONLY THE WORK ..I.. THIS PERMIT COVERS WORK TO
t: HE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUIRJO
Grading
Recording Fee
D MARQUEES, ETC.) WIULREQ IR
OMAIN (CURBS, SIDEWALKS, DRIVEWAYS, B a
SEPARATEPERMISSION.
Engr. Review
City Surcharge
PERMIT APPLICATION: IN DAYS
PERMIT UNIM I YEAR- PROVID 0 WORK IS STARTED WITHIN 1NDAYS
Engr. Inspection
State Surcharge
2�i
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT' ON BEHALF OF 1111 OR HER SPOUSE. HERS, ASSIGNS AND SUDDES.RS
Traffic Mitigation
Plan Chit Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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Receipt #
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FRO" ANY AND
ALL CLAIMS FOR DAMAGES OFINHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
Fire Review
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
Fire Inspection
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0 EMED TO MODIFY I OR REDUCE ANY REQUIREMENT OF ANY 0 Y ORDINANCE
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ANITY=N
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Receipt #
I HEREBY ACKNOWLE BE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND T14AT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE OF THE STATE OF WASHINGTON RELATING TO
B usding O%at or 1,19/her Deputy: and Foos am paid, an,
FOR INSPECTION mr.lPti.m.knoyldond In space Pffov!�.d,
WORKAOMS-COMPENS CE.4ND ACW IS
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DATE
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771-0220 RECEASIED BY D 1,
ATTENTION
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.
Y.EL1,0--'1N.PEC
ORIGINAL R
CATE OF OCCUPANCY HAS BEEN GRANTED. LED SECTION 109
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ................
Wall . .......... ..........
Pier/Porch .................
Retaining Wall ...........
Stab Insulation ..........
0
PLUMBING:
Underground .............
Rough -In
M
C
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0,
Commercial Final
-40
HEATING:
Gas Test ...............
0
Gas Piping
Equipment .................
Commercial Final
EXTERIOR SHEATHING
M M
NAILING ..........................
a 65
0
0
FRAMING
C:
FIRST FLOOR FRAMING
Q 0
INSULATION ..................
Ir
Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
0
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................