20020125.pdfATE RECEIVED
PERMIT EXPIRES
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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ADDRESS
16115 N Meadowdale Rd
OWNER NAMENAME OF BUSINESS
Neith Van Meter
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AILING ADDRESS
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16115 N Meadowdale Rd
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WNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY zip TELEPHONE
NAME
Fast Waber lifeater
ENGINEERING REVEWEDIDATE
ADDRESS
132 AVe NE
,12601
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THISPERMITAUTHO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DDNE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THEP BAD
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DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REG
GRADINGIFILL
SEPARATE PERMISSION.
PERMIT APPLICATION: 180DAYS
s;APe-suRCHARGE
T PERMITLIMIT.1 YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS
END, 11W FEES
REV
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
*A PLICANT, ON BEHALF OF .15 OR HER SPOUSE. HEIRS. ASSIGN$ AND SUCCESORS
ENG. wspsc NON FEE
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
NSPECTION FEE
A L CLAIMS FOR DAMAG S F WHATEVER NATURE, ARISING R ECTLY OR INDIRECTLY
CE"
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THISI PERMIT SHALL NOT BE
DEEMED TO MODIFY. WAIVE 0 REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
PLANCHEC� DEPOSIT
ADD LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PAOVISION,"
RECEIPT
TOTAL AMOUNT DUE I
I HEREBY ACKNOW EDOE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DUI-Y AUTHORIZED AGENT Or
THEOWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRU"
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TION, AND IN DO NO THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
I N VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTION ImIlpt 11 Ilk—Ildgla a Spam La —mad.
VYOF1.SN I MPSI,11ATIGN �NSUFANCI AND FEW IS.11,
OFFICIALS SIGNATURE DATE
SIGNED
(425)DATE
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771-0220 RELEASED BY DAE
A17ENTION
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL -FILE YELLOW INSPECTOR
FAX PINK - OWNER GOLD - ASSESSOR
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKfI ...........
FOUNDATION:
Footing .............
wall .....................
Pier/Porch .................
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Retaining Wall
Slab Insulation ..........
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PLUMBING;
Underground .............
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C3 M
Rough -in ................
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0
0
Commercial Final
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HEATING:
M
10-4
Gas Test ....................
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Gas Piping .............
Equipment
Commercial Final
IT1 ITI
EXTERIOR SHEATHING
NAILING ..........................
0
0
FRAMING ........................
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FIRST FLOOR FRAMING
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INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
A "S—az—
OCCUPANCY ..................
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