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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PROGRESS INSPECTIONS PER UBC 108/FINAIL INSPECTION REO'D
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[VALUATION
Description
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Plan Check
HEAT SOURCE
LOT SLOPE %
Building
PLAN C757
VESTED DATE
Plumbing
Mechanical
THIS PERMITAUTHORIZES ONLY THE OAK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS SEIGGUEES, ETC.) WILL REQUIRE
SEPARATE PERMi MAR N.
Grading
Engr. Review
PEA ITAPPLICATION: INDAYS
PERMIT Lesse,YEAR-PROVID DWOFIKIISTARTEDWIIHIN 1-DAYS
E. BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
'APPLICANT. ON BEHALF OF HIS On HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HAS LESS THE Ciry OF
2 EDMOND% WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Traffic Mitigation
Fire Review
IALL CLAJMS to DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SH Lt NOT HE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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X, NOR LANUT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE F, VISION,'
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 OWNUL I AGREE TO COMPLY WWfH CITY AND STATE LAWS REGULATING CONSTRUC_
TION; AND IN DOING THE IWORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELRTING TO FOR INSPECTION
WORKMEN'S COMPeNSATiQN:!qSURANCE AND ROW 1&27�
SIG (o A ENT) DATE SIGNED '25)
771-0220
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ON EXT 1333
I E OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
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Description
FEE
Recording Fee
City Surcharge
State Surcharge
Plan Chit Deposit
Receipt #
Total Amount Due
Receipt #
JCATION APPROVAL
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ATURBI . DATE
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PINK - �W E GOLD - ASSESSOR
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .................
FOUNDATION:
Footing ................
Wait .....................
Pier/Porch ..............
Retaining Wall
Slab Insulation
PLUMBING:
Underground ...........
Rough -in ...................
Commercial Final
HEATING:
GasTest ....................
Gas Piping .............
Equipment ..........
Commercial Final
EXTERIOR SHEATHING
NAILING .......... ...............
FRAMING .............
FIRST FLOOR FRAMING
INSULATION ..................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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OCCUPANCY ..................
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