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CITY OF EDMONDS ZONE �UMBER �(irl 2 -�
CONSTRUCTION PERMIT APPLICATION JOB ZI—Rvc tc) SUITE/APT#
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REMARKS
PROGRESS INSPECTIONS PER UBC 110101FINAL INSPECTION REaD
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Mechanical
THIS PERMIT AVTHORCMS ONLY THE WORK NOTED. THIS PERMIT COVEI45 WORK TO
Lt BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
Recording Fee
a - .) WILL REQUIRE
3 DOMAIN ICURBS. SIDEWALKS. DRIVEWAYS, MAROUCES"'IC
tr SEPARATE PERMISSION.
Engr, Review
City Su(chatge
UGMITAPPULCATION: 180DAYS
PERMIT LIMIT, I YEAR - PROVIDED WORK IS STARTED WITHIN HIS SAYS
Engr, Inspection
Stale Surcharge
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICA ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCISOLu,
Traffic Miligabon
Plan Chk Deposit
11 IN INTERIWS.T. AGREES TO INDIMN11, .1111111 AND HOLD HAIM1111 Till CITY 01
Receipt #
EDMONDS. WASHINGTON ' IT S OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY ANT;
ALLCLAJMSFOSDAMA ESOFWHAMER NAIURE.AlitSINOt)IRECTLYORINDiftEV,[Ly
Fire Review
FROM THE ISSUAN OF THIS PERMIT ISSUANCE OF THIS PEnMIT SHALL NOT ITF
- GIVE
EWA
Fire Inspection
Total Amount Due-jj
DEEMED TO MODIFQ OR REDUCE ANY REQUIREMENT Of MY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION
I
'Landscape Inalt.
Receipt III
I HERE ACKNOWLEDGE THAT I HAVE HEAR THIS APPLICATION, THAI YHE INFORMATION
APPLICATION APPROVAL
GIVE" IS CORRECT, AND THAT I AM THE OWNER� OR THE DULY AUTHORIZED AGENT OF
THE OWNER . I AGREE TO COMPLY WITH CITY 94D STATE LAWS REGULATING CONSTRUC
CALL
In .. -pp, wa,ea, a.,. pannit unfil'igniel It, pat
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPWYEO
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Dan ding oftwial a, tu,ufu, Deputy: and Fees aid ptad. and
Ilellpi 1% 401-Ildged In speca pralfidkxL
WORKMENS COMPENS�A�f
OfFIOM5 SIGNATURE
(OWNER 0! T) ;CEANDRCW1927. )ATE SIOVD
(425)
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'!j��TURE
L�2 7/6 17
771-0220
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ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
10101
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ................
wall ..., .................
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Pier/Porch .................
0
Retaining Wall ...........
Slab Insulation ..........
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PLUMBING:
M
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Underground ......... ..
M
0
0
C
Rough -In
Commercial Final
M
HEATING:
C
E:
Gas Test ..........
Gas Piping ..�. ...........
0 71
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Equipment .. ...............
M M
Commercial Final
0 5; 1
0
0
EXTER OR SHEATHING
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NAILING ..........................
90)
FRAMING ........................
FIRST FLOOR FRAMING..;
INSULATION .............
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Floor Insulation
Wall Insulation ..........
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Coiling Insulation
0
SHEETROCK NAILING
M
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..............
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