20020222.pdfDATE
PERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT
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NUIVIBER
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT#
OWNER NAMEINAME
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FEES
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ADDRESS
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY TELEPHONE
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NAME 1)
ADDRESS
FIRE REVIEWED By DATE
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VALUATION FEE
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PLUMBING
IRIS PERMIT AUTHO 1111 ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLYANY CONSTRUCTION ON TH E PUBLIC
GRADINGIFILL
DOMAIN JCURBS, SIDEWALKS, DRIVEWAYS , MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
IX
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SES SACK OF PINK PERMIT FOR MORE INFORMATION
'A PLICANT. ON SEHALrOF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
ENG, INSPECTION FEE
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAP NO
E MONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
A L CLAIMS FOR DAMAGESOF WHATEVER NATURE. ARISING DIRICTLYOR INDIRECTLY
x FIT M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
�,j DEEMED TO MODIFY, WAIVE 08 REDUCE ANY REQUIREMENT OF ANY CITYORDINANCE
PLAN CHECK DEPOSIT 'E"'PTI 5 10
0 NOR LIMIT IN ANY WAYTHECIT 'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
TOTAL AMOUNT DUE RECEIPT SO I
I HERESY ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION, THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING C STRUC
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CALL
HON AND IN DOING THE WORK AUTHORIZED THEREBY, NO PEAS
I IN VIOLATION OFP F THE STATE OF WASH] NGTON RE ATING TO
FOR INSPECTION '-Pl'-�-Xdp -.p--d,
771-0221
PECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK OWNER . GOLD - ASSESSOR
5198
Tonkin Hoyne Lokan
ARCHITECTURE & URBAN DESIGN
204 FIRST AVENUE SOUTH SSATTLE,WASHINOTON9M4
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Aker's House Remodel
1047 Bell Street
01. a, N11—
1047 Bell Stt Ed—ds. W4�h ��t-
Site
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
M[EMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
__�ENGINEERING DIVISION DATE2k4--'
PLANNING DIVISION DATE
PROJECT�__ N-e-a_-,or)
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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
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PERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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a Copy of CORRECTION NOTICE given to owner/contractor by inspector
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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 ...........
Slab Insulation
PLUMBING:
Underground ; ............
MS
Rough -in ...................
Commercial Final
HEATING:
Gas Test
Gas Piping ...........
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ... .......................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION
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Floor Insulation
Wall Insulation ...........
Calling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
IS,
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OCCUPANCY ..................
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