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THIS PERMITAUTHORGIDES ONLY11HE ORKNOTED. THIS PERMIT COVERS WORKTO
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t 1111"1 Oil P11 PROPERTY ON11.11. ANY CO.S11FRICTION ON THE PUBLIC
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DOMAIN JCIURBS, SIDENVALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATEPERMISSION.
Engr. Review
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City Surcharge
"ERMMAPPUCATION 180DAYS
PERMIT Lullm I YEAIR - PROVIDED WORK 19 STARTED WITHIN 160 DAYS
Engr. Inspection
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State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
So
'APPLICAN7, ON BEHAL OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
Traffic Mitigation
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Plan Chk Deposit
I. INTEREST, AGREES TO INDEIANII DEFEND AND HOLD HARMLESS THE CITY OF
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EDMONDS, WASHINGTON, ITS OFFICIALS, 11,1110YE11, AND AGENTS Flo ANY A".
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
Fire Review
FROM Till ISSUANCE 01 THIS PERMIT IESUANCi OF THIS PERMIT SHALL NOT BE
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DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINNANOCE
Fire Inspection I
To,., A.
N OR LIMIT IN ANY WAY THE CFN`S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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Receipt
I HEREBY ACKNOWLE BE THAT I HAVE READ Ti [IS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVE IS CORRE" AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT JOF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CON T.UC
CALL
Th'a applicanon i—or apann!' until $10 a.d b, tha
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PSLT07yUE`D'
TION; AND DING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EM un
1. IRDLAT .1 THE LA IT;TE OF WASHINGTON 11 ]NO TO
24 'T G To
Set ilding
FOR INSPECTION
Officialn hisihar Deputy: and Fee.
lac.1p, 1—fincaddit.al 1. epted
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WORKME G.MPBNRAT, TIC, 18.27.
OF
LS SIGNA URE
DATE
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ML I= 71 RELEASED BY DOE
ATTENTION EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221 ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
10101
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...............
FOUNDATION:
Footing ......................
Wall
Z
Pier/Porch
0
Retaining Wall
Slab Insulation ..........
--I -n
PLUMBING:
M
C
M
Underground .............
0
0
Rough -in .............
C,
Commercial Final
j
jo —4
HEATING:
4
>
Gas Test .............
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Gas Piping ...........
0 T1
Equipment ..........
ITI M
Commercial Final
a 6;
0
EXTERIOR SHEATHING
C
NAILING
C co,
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FRAMING ..................
FIRST FLOOR FRAMING
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INSULATION ...........
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Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
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SHEETROCK NAILING
ITI
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................