20020156.pdf� I �DATE RECEIV�ED
I I I PERMIT EXPIR
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OWNER NAME A F SUSINE 4VZ V1
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PROPERTY TAX ACCOUNT 13CEL NO. COMPLETE EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED
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NEW RESIDENTIAL PLUMBING
t MECH ALLOWED PROPOSED FRONT SIDE PEAR FRONT UP SIDE REAR
ADDITION COMMERCIAL C MPUANCE OR
CHAN15E OF USE
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REMARKS
FIOGRESS INSPECTIONS PER UBC 108tFINAL INSPECTION Rr=O'D �15
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PLAN CHECK
UMBING
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
...ECHANICAL
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
GRADING!FILL
SEPARATE PERMISSION. —
STATE SURCHARGE
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P MIT APPLICATION: 180 DAYS
PERMIT LIMIT., I YEAR � PROVIDED WORK IS STARTED WITHIN 160 DAYS
ENG. REVIEW FEES
SEC BACK OF PINK PERMIT FOR MORE INFORMATION
'AP LICANT. ON BEHALF 011111 ON 11111 SIOUSE� 11111S. ASSIGNS AID SUCC,SORS
ENG. INSPECTION FEE
IN INTEREST AGR2El TO INIIIIINIly, DEFEND AND HOLD HARMLESS CITY OF
LANDSCAP NG
FTHE
EDMONDS. WA HINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS F ANYAND
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INSPECTION FEE
ALL CLAIMS FOR DAMAGES OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
;j 11 1 THE ISSUANCE 11 THIS PERMIT. ISSUANCE OF THIS PERMIT $.ALL NOT BE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
R CEIPT/6/0;5,;l
0 NORUMIT INANYWAYTHE CITY'SABILLITY TOENFORCE ANYOTDINANCE PROVISION,�
-
TOTAL AMOUNT DUE
IRECEIPT/V
I PERES ACKNOWLEDGE THAT I HAVE READ THIS APPUCATK)M THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
APPLIdATIlON A0ROVAL
T EOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWSREGULATJNO IONSTRUC.
TtON ' AND IN DOING THE WORK AUTHORIZ D THEREBY. NO PERSON WILL BE EMPLOYED
CALL
Su" Th.. �ppfi.. 0 slo.� b, IhP
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION ........ .
WORKMEN'S COMPENSATI�RAkURA CE AND ROW 18.27.
9AT�'
___T7 ATE SIGNED
(425)
77
ATTENTION
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'§ELEASED BY MTE
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224 W(
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTUR! UNTIL
771-0221
"OR"
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
'NAL�LER YELLOW, &SPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
N E GOLD - ASSESSOR
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YINAL PROJECT APPROVAL FORM
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DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTWNT DATE�-
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE
PROJECT
SITE ADDRES
PERMIT S� �Z� ------PATE INSPECTED-
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DESCRIPTION OF WORK TO BE INSPECTED--,_���.
A field inspection was conducted to determine fWal compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release 'of
PERFO E LRQNDS and the granting of
�RANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
c3 Copy of CORRECTION NOTICE given to owner/contractor by inspector
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2.
3.
RE-INSpEcTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ..............
FOUNDATION:
Footing ................
Wait..........................
z
PierlPorch ..........
Retaining Wall ...........
0
Stab Insulation ..........
PLUMBING:
a ITI
Underground .............
0
Rough -In ...................
Commercial Final
IT1
171
HEATING:
IS
Gas Test ..........
GasPiping .................
Equipment ................
x
IT In
Commercial Final
0
0
EXTERIOR SHEATHING
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NAILING ..........................
1710
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation
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Calling Insulation
0
SHEETRoCK NAILING
IT!
SPECIAL INSPECTION