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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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Engr. Review
PE ITAPPLICATION; INDAYS
PERMIT LIMIT I YEAR - PROVIDED WOR IS STARTEDWITHIN 180 DAYS
Engr. Inspection
SEE RACKOPPINKPIERMITy FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, he OF11CIA11, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
AULCLAJMS1OR E8 OF WHATEVER NATURE ARISING EARECT1.1 0. INDIRECT
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FRO. THE rSSU=G
OF THIS PERMIT. SSUANCi OF THIS PERMIT SHALL NOT
9 DEEMED TO MODIFY, WAIVE 0 REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT HE INFORMATION
GIVEN IS CORRECT 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.
TION; AND IN DOING THE WOR AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON AELATING10
FOR INSPECTI(
WORKMENS COMPENSATIONL�JS��4C9 AND RCW lf27.
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DATE SIGNEP
(425)
771-0220
NTION 7-1—
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-022
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
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CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
10101
Recording Fee
City Surcharge
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Plan Chk Deposit
Receipt #
Total Amount Due
Receipt #
APPLICATION APP
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APPROVED BY PLANNING
DEVELOPMENT SERVICES rTR,
CITY OF EDMONDS CITY COPY
LECAL DESCRIPTION: SEE ATTACHED SURVEY
TAX ASSESSORS PARCEL J; 072704-4-014-0004
PROXCT 17J30 76(h AM
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OWNERS. KEN AND WIND)
DESIGN DADS: SEISMIC ZONE J. EXPOSURE 8. 80 MPH
ROOF: IOPSF DEAD LOAD, 25PSF LIVE LOAD - 3.5 PSF.
ADDRESS: SAME AS ABOV
PHONE 425 775 0289
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO To: PERMIT coompqAmp, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
D-,r,,i Lpgfel ENGINEERING DIVISION DATE-2Lz--d02—
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PLANNING DIVISION DATE
PROJECT
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DESCRIPTION OF WORK TO BE INSPECTED L106(—
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
u 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
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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FINAL APPROVAL FOR