20020299.pdfor, "ICIIVIO- ji PERMIT
CITY OF EDMONDS
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NU'MBER
CONSTRUCTION PERMIT APPLICATION
JAOGREIS
OWNER MAMEINAME OF GUSI�FSS
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ADDRESS
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY
PURSITANT Tf) Prnr to Ir"I"n
NAME APPMURUREGULAMRVALVE(PRV)
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REMARKS
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Description FEE Description FEE
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Plan Check
Oil
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PLAN CHECK NO: VESTID DATE
Plumbing
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Mechanical
THIS PERMIT AUTHORIZES ONLY WE ORK NOTED. THIS PERMIT COVERS WORK 10
Iz BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC
:1 0 MARQUEES, ETCJ WILL REQUIRE
:3 OMJUN JOUREIS, SIDEWALKS, DRIVEWAYS
Grading Recording Fee
SEPARATE Sale,
PERM;
Engi. Review City Surcharge
P1* MIT APPLICATION. IN DAYS
PERMIT LIMIT I Y EAR-PROVIDEOW RK IS STARTED WITHIN INDAYS
Inspection State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMA710M
_!ngr.
'APPLICAW, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
1ralfic Miligalion Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, AND
Receipt #
ADEN S FROM ANY AND
EMPLOYEES. T
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECHY
Fire Review
FROM THE ISSUANCE OF THIS PERMIT ISSUANCF OF THIS PERMIT SHALL NOT HE
DEEMED TO MODIFY, WAIVE OR REDUCE OF
Fire hispoction Total Amount Due
ANY REQUIREMENT ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION
I
Landscape InFP. Receiptill
I HEREBY ACKNOWLEO THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
APPLICATION APPROVAL
GIVE IS CORRECT, AND THAT I AM THE OWNER OR THE DULY AUTHORIZED AGENT OF
T 9 OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
IN. applinall.. le NO a NNNI -net ligntul b, and
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION ODE 01 THE ITAT 01 WASHINGTON 1411TIN. I-
OF THEAPN._N
EuXteng oNeval at his/her Deputy; and Fees are paid. and
FOR INSPECTION ne'.1pli—k—Weg,di—paue p—Ided.
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WORKMENS OMPENS CE AND HGW 10 27.
a E (0 9 0 GE CA F SIGNED
(425)
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771-0220
RELEASED BY V DATE'
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. UBC SECTION 109
FAX PINK - OWNER GOLD - ASSESSOR
10101
AWL
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ..............
Wall .......................
PlarlPorch .............
Retaining Well ...........
Stab Insulation ..........
PLUMBING;
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am
Underground
a
M 0
-40
Rough4n ...................
0 C
Commercial Final.—
M
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HEATING:
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'0-4
Gas Test ....................
>
Gas Piping ..............
Equipment .................
0 -n
Commercial Final
m M
co
EXTERIOR SHEATHING
0
0
NAILING .......... ...........
FRAMING ..............
ITIO
FIRST FLOOR FRAMING...
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INSULATION ...................
>
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
z
0
SHEETROCK NAILING
0
M
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................