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IHEREB ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
APPLiCATION
APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE OULY AUTHORIZED AGENT OF
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
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TION AND IN OOINGTHEWORBAUTHOEIZEDT EMERY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTION ', I,'I.bg.d,o op ... p—al-
WORKMEN'S COMPENSA SURANCE AND ACW 18.27
OFFI IA .5PN T I. DATE
OWNER 0 A NTI
D E SIGNED
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
-.14GINAL-PILE YELLOIN- INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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PINK OWNER GOLD -ASSESSOR
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BUILDING DEPARTMENT
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ADDRESS
CITY COPY
OWNER
APPROVED DATE:
UAi i-04;
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RECEIVED
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PERMrr NUMBER
FEUD 2 1 "'2
7-1-98
DEVELOPMENT SERVICES CTS.
CITY OF EDMONDS
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATE 2-
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE
PROJEC
SITE ADDRESS
PERMIT # 009- - 01 oRef ADB DATEINSPECTED
DESCRIPTION OF WORK TO BE INSPECTEI)2:�_����e?- 4f-
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 ofCONDITIONS given to owner/contractor by inspector
1.
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
Date Sign_
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
Wall ..................
PleriPorch .................
Retalnlng Wall ...........
0
Slab Insulation ..........
PLUMBING:
Underground .............
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Rough -in ...................
0
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Commercial Final
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HEATING:
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Gas Test ....................
Gas Piping ..............
Equipment ...........
Commercial Final
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EXTERIOR SHEATHING
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NAILING ..........................
FRAMING .................
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FIRST FLOOR FRAMING
INSULATION ..........
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Floor Insulation
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Wall Insulation ..........
Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION