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CONSTRUCTION PERMIT APPLICATION JOB SUITEIAKO
ADDRESS
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YES E3 NO
ROPERTY TAX ACCOUNT BY
EPA F�11. SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED A.." PROPOSED
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0 PLUMBING I NEON
LOT COVERAGE REQUIRED SMACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED PRopos D FRONT SIDE REAR FRONT UnSIDE BEAR
1:1 ADDITION
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0 REPAIR
0 F NCE
[3 GRADING CYDS ( X FT)
REMARKS
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PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REOD
VALUATION $
Description
P
Plan Check
HEAT SOURCE GLAZING
LOT SLOPE
LOT SLOPE Building
AAIE
nE. P
PLAN CHECK NO: nED DATE Plumbing
Mechanical
,.IT COVERS WORK TO
THIS PERMIT AUTHORIZES ONLYTHE WORK NOTED. THIS PERMIT COVERS WORK TO
t:
KING THE PUBLIC
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BE DONE ON PRIVATE PROPERIFY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CLIFIRS. SIDEWAMS, DRIVEWAYS, MMQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION. Engr. Roview
PER ITAPPLICATION: 180DAYS
A,
PERMIT UUM. I YEAR - PROVIDE WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF 01 HIS 01 HER SPOUSE, HEIRS, ASSIGNS AND IUICESOFIS Traffic Mitigation
IN INTEREST. AGREES TO INOEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Review
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
I G
FROMTHE ISSUANCE OF THIS PERMIT. SSUANCE OF THIS PERMIT SHALL N T F` Fire Inspection
0
CE
DEEMED TO MODIFY. WAVE 01 1EDUCE ANY HEOUIREMENT OF ANY CITY ORDINAN E
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROWSION.'
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER ' AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
N VIOLATIO E
I I N OF THE LABOR COD OF THNCTWATE OF WASHINGTON RELATING TO FOR INSPECTI(
WORKMEN'S COMPENSATION INSURANCE 18.27,
SIG RE R A DATE 17NED (425)
.2_ 771-0220
ATTEN EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A SU DING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AN APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
10101
Recording Fee
City Surcharge
StateSurcharge
Plan Chk Deposit
Receipt #
TotalAmountDue
Receipt #
ICATION APPROVAL
NI,fh., Dty: nd F .1. p.1d. .�d
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE-1-1-0 _2—
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ENGINEERING DIVISION DATIE�-
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PROJECT
SITE ADDRESS
PERmrr#�Lo0?--Q/L1ff- ADB# DATE INSPECTED =01 —0 Z_
DESCRIPTION OF WORK TO BE INSPECTED po q11 /2-/', � Ic
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
o 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
1
2. IMIGROFILM
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Si
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
0
Stab Insulation ..........
PLUMBING:
Underground .............
M
Rough -in
M
Commercial Final
HEATING:
A
011
Gas Test ..............
C
Gas Piping ..........
Equipment ............
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Commercial Final
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EXTERIOR SHEATHING
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NAILING ..........................
0
0 M
FRAMING ........................
FIRST FLOOR FRAMING
rn 0
INSULATION ...................
Floor Insulation
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Wall Insulation ...........
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Ceiling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
ITI
MISCELLANEOUS
FINAL APPROVAL FOR
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