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CITY OF EDMONDS
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REMARKS
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PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
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VALUATION 7/,/, Clll�
Description FEE
Plan Check ill �Fa_
PLA14 CHECK NO: el-41 I
I 115TED DATE
Plumbing
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Mechanical
THIS PERMIT AUTHORIZES ONLYTHE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
23
mg
Recording Fee
DOMAIN (CURBS. SIDEWALKS, DRIVENVAYS, MARQUEES, ETC.) WILL REQUIRE
In SEPARATE PERMISSION.
2
Engr. LReview
50
City Surcharge
P, A TrAPPLICATION: IN DAYS
PERMIT UNTR I Y. - PROVID D WORK IS STARTED WITHIN too DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
State Surcharge
'APPUC (111 UE-11 01 HIS OR HE" I E, HE RS, ASSIGNS AND SUCCESORS
AIR FOUS I
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY F
EDMOND WAIHIN N, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM A I AND
Fire Review
Receipt #
L CLAIMS' FOR DAGMTAOCI OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Fire Inspection
Torat-Ayrautratrue
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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:I=
IHEREOY ACKNOWLEDGE THAT I HAVE BUD THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT.* AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER, I AGREE TO COMP WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
(seat. pe-It.efil algrtsd by th.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR ODE OF THE STATE OF WASHINGTON RELATING TO
By'ThIs.pplisiame
ding Offielal w Issiter Deply� we Foes am 1.1d, old
FOR INSPECTION me.11" 1. a.*—I.dqad 1. spes. p—m.d.
WORKMEN3.�NSATIO INSURANCE AND RCVV 18.17,
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771-0220
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FASED Bi- ATE
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EXT 1333
1�2YL
I = OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE YELLO INSPECT R
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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Height Calculation Worksheet
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Address: /c)
Date:
inspector(s): Vv'\S
1. Datum Point:
2. Datum Point Elevation: 15-7 9"
A
3. Average Gradd
4. Maximum Elevation Allowed: (average grade) 25'
MO
5. Reference Point Elevation Shot to House:
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(datum elevation)+ -7,:5& (grade to transit level line shot to house)= LG-5-
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6. Measurements from line shot onto house to roof ridge:
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7. Actual Elevap9p: Lj��196(reference point elevation) +, (measurements
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'V�(aetual) is greater /liess thx� (allowed); therefore the house is/
Is not over the height requirenie—nf—pe—r E45—C16.20.30 requirements
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By PLANNINC,'
APPROV ED
CITY
FINAL PROJECT -APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATE
OAILB�ff ENGINEERING DIVISION
IMA elL DATE
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PLANNING DIVISION DATE
PROJECT W-4"-
SITE ADDRESS
PERMIT # ADB# —DATE INSPECTED-4�St�
DESCRIPTION OF WORK TO BE INSPECTED W k4t/t'-
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 releise of
PERFORMANCE BONDS and the granting of:
-ZGRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy ofCONDITIONS given to owner/contractor by inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a 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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MBMOTO: pERWr COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE -
ENGINEERING DIVISION DATE-1 11
PLANNING DIVISION DATE-
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denotes that there are no objections from the above signed Dep artment to the release of
LE LM_ANCEBONDS and the granting of
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Date- sign-
ocaprvi.docj:temp.-bldr.formsIO/OI
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
MIS
SETBACKS .....................
FOUNDATION:
Footing ............
wall ...........
Pier/Porch .................
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Retaining Wall ...........
Slab Insulation 0
PLUMBING:
Underground .............
Rough -in ................... am
C
m
0
Commercial Final 0
C
HEATING: 3:
m
IS m
Gas Test ..................
Gas Piping ............
Equipment ................. 0)
Commercial Final
d 5�
EXTERIOR SHEATHING
NAILING ................ ...............
0 CA
FRAMING .................... 0Fn
03
FIRST FLOOR FRAMIN4 M 0
INSULATION ...................
Floor Insulation
Wall Insulation .......... z
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Ceiling Insulation
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SHEETROCK NAILING z
0
SPECIAL INSPECTION
m
MISCELLANEOUS ..........
FINAL APPROVAL FOR C3
OCCUPANCY ..............
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AmoutPald
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watecirrmeter In
Amount PhId_ReM1P1#_
Datel"111111thaSOd
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