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//O,�_ I I PERMIT EXPIRES
USE PERMIT
CITY OF EDMONDS ZONE _14 U M B E R 2M2 _I�)/221
CONSTRUCTION PERMIT APPLICATION JA280RESS IUITEIAPTI
OWNER NAMENAME OF BUSINESS &hn ond5
f 49, 1 e c),)4 t. FLAT NAMEISUBDIVIStON NO. I LOT I'D Ll N .
MAILING ADDRESS LID FEE S
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NAME NEVER SIZE I LINE SI PRV REQUIR D
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ADDRESS REMaRKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDMINAGE
NAME
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ENGINEERING REVIEWEIUDATE
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REMARKS
DEMOLISH TANK E] OTHER
GARAGE RETAINING WALL
CARPORT ROOKERY RENEWAL
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DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER BC 11081MINAL INSPECTION RECI`D
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Description
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FEE
Description
FEE
Plan Check
HEAT SOURCE LOT SLOPE %
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Building
PLAN CHECK NO: VESTED DATE
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Plumbing
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THIS PERMIT AUTHORIZES ONLY THE ORKNOTED. THIS PERMIT COVERS WORK TO
echanical
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I-- BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON 714E PUBLIC
Grading
Recording Fee
23 DOMAIN JCURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr, Review
City Surcharge
IeE MIT APPLICATION: 180 DAYS
PERMIT Lai I Y BAN - PROVIDED W IRK IS STARTED WITHIN IN DAYS
Engr. Inspection
State Surcharge
81 SACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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Receipt #
2 EDMONDS 0 FICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
CLAIM�WAS"INGTON, CIS F
IA. FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Review
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT E
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!3 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUIREME F CITY ORDINANOE
Fire Inspection
Total Amount Due
0 NOR LIMIT IN ANY WAY THE CITYs ABILITY TO ENFORCE ANY ORDINANCE PROVISION.�
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THEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
—
APPLICATION APPROVAL
GIVEN IS CORRECC AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMP WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This applica'an Is nen.0 Peneft Urall signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
Se IldlegOffid.h.,bleth., aputy:rsed Fees are paid, and
FOR INSPECTION .iirl ika.wI.dg.d1 In ep..a re.sid.d.
WORKMEN'S COMPENS=S=CE AND ROW It ... 7.
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SJQNATURE (OWNER 04AGENT) DATE SIGNED
(425)
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RELE9SED 89 BOB
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
1
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE YELLO - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK�OWNER GOLD -ASSESSOR
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
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PLANNING DIVISION DATE-
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A field inspection was conducted to determine fluid compliance with approved plans. Final approval
denotes that there are no objections from, the above signed Department to the release of
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RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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INSPECTOR
DATE APPROVED
SETBACKS ...............
FOUNDATION:
Footing ...........
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Pier/Porch .................
Retaining Wall ...........
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Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
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HEATING:
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Gas Test ....................
Gas Piping .................
Equipment ............
Commercial Final
EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ........................
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FIRST FLOOR FRAMING...
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INSULATION . ............
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Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
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OCCUPANCY .................. Ida
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