20020258.pdfPERMIT EXPIRES
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CONSTRUCTION PERMIT APPL;ICATION 'AOC R E S S
OWNER NAMEMAME OF BUSINESS
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REMARKS
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MECHANICAL
THISPERMITAUTHO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES� ETQ) WILL REQUIRE
GRADINGIFILL
SEPARATE PERMISSION�
STATE SURCHARGE
PE MIT APPLICATION: 180 DAYS
PERMIT LIMIT', I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW TEES JL ki f"oL
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
E N G, IN SP EC T 10 N F E E
1,� ;APPLICANT, ON BEHAL OF HIS OR HER SPOUSE, HEIRS� ASSIGNS AND SUCCESOPS
I' Ss HE CITY OF
N ATER11T. AGREES TO INDEMNIFY. DEFEND AND HOLD HARM11
LANDICAPINO
2 EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENT S FROM ANY AND
INSPECTION FEE
ALLCLAIMS FOR DAMAGES OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
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FfECEIPT,
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS P AMIT SHALL NOT BE
D EMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
ANY ORDINANCE PROVISIONr
PLAN CHECK DEPOSIT
ol NOR LIMIT IN ANY WAYIHE CITY'l ABILITY TO IN104CE
TOTAL AMOUNT DUE
RE
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I HEREBY ACKNOWLEDGE THATI HAVE READ THIS APPLICATION, THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DIJLY AUTHORIZE. AGENT OF
THE OWNERr I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
T � IPII�al 1� 1-11 Il �11 11
TION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
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IN V16LATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
lKdq.d �
WORKMEN'S COMPENS�=ANCE AND RCW IS. 7
DATE SIGNED
(425)
OFF IALS SIGNATU
SiGNUE /(NE,AG('�AGENT).
771 -0220
R '71 DATE
ATTENTION
EXT 1333
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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. UBC SECTION 109
FAX
PINK OWNER - GOLD -ASSESSOR
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Height Calculation Worksheet
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Address: p 0
Date:
Inspector(s):
1. Datum Point:
2. Datum Point Elevation:
0.
ge Grade:
3. Averag
4. Maximum Elevation A]Iowed:6'5 gmd.)+��—
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5. Reference Point Elevation Shot to House:
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6. Measurements from line shot onto house to roof ridge:
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7. Actual Elevatiomq (reference point elevation) 4e, F, (measurements
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Conclusion:
(actual) is greater(I—,ss (allowed); therefore the house is/
is not over the height requireme—ni —per EJDc 16.20.3o requirements
FINA-1, LROJECT APPROVAL 1,ARM
TO.
DATE:
WMO TO: pERMrr COORDINATOR, BUMDING DIVISION
FROM: ------FIRE DEPARIWNT DATE —
PLANNING DIVISION DATE—
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DESCRIPTION OF WORK TO BE INSPECTED
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denotes that there are no objections from the above signed Department to the release :of
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PERFO—RMANCE BONDS and the granting of:
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FINAL PROJECT APPROVAL
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RE_INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date_ Sign_
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FIN -L PROJECT APPROVAL. -)RM,
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
ENGINEERING DIVISION DATE
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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 ................
vvM
b�—/
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground
Rough -in ...............
Commercial Final
HEATING:
Gas Test ....................
Ga a Pip Ing ................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING .....................
S_
AA FRAMING ........................
2e,�)7, t&" czvTtc�A&�__
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY
..................
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