20020320.pdf1 DATE RECEIVED
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CITY OF EDIVIONDiIi—
CONSTRUCTION PERMIT APPLICATION
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REMARKS
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THIS PERMIT AUTHORIZES ONLY THE IN FIX NOTED, THIS PERMIT COVERS WORK TO
HE DONE ON PRIVATE PROPERTY ONLY. ANY CONST UCTIONONTHCPUBUC
Grading
23 DOMAIN (CURBS, SIDEWAU(S. DRIVEWAYS, MARQUEES, ETC.) WILL. REQUIRE
SEPARATE PERMISSION.
Engr. Review
PER ITAPPLICATION: 183DAYS
PERMIT LORD I YEAR � PROVID D WORK IS STARTED WITHIN I no DAYS
Engr. Inspection
S6rBACKO PINK PERMIT FOR MORE INFORMATION
'APPLICA . ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
IN INTEREST, AGREES TO INIE111111, DEFEND AND HOLD HARMLESS Till CITY .1
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
Fire Review
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANIC OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
Fire Inspection
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Lerida... In.p.
I HEREBY ACKNOWLE BE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONVRUC_
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR ODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTI(
WORKMEN'�,W,ENSATION I SURANCE AND RCW 18-27,
11� TuiRkaw—No G D TEISIGI�'2
(425)
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�A �A
771-0220
ATTENTION
EXr 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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
10/01
PER UBC
NNW
Recording Fee
City Surcharge
State tsurcnarge
Plan Chk Deposit
Receipt yy
Total Amount Due
.. _1011 I zill /Y
APPLICATION APPROVAL
This appreau-noto. parout,son aqued by am
Iding Offichn,r theater Deputy: and Foos am paid. and
mo.int beitclanout.d9ed In so ... pe.1d.d.
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APPROVED AS NOTED
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Date:
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ADD GUTTERSIDOWNSPOIJTS
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OWNER/C0NWCToR IS RESPONSIBLE 2 m 1:
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RECEIV
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----------------
--------- .,Cop�y MAR 19 2002 11
BUILDING DEPT.
FINAL PROJECT APPROVAL FORM
TO:
DATE,
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
—ENGINEERING DIVISION DATE z
PLANNING DIVISION DATE�—
PROJECI�--
SITE ADDRESS . .....
PERMIT# ADB#
INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
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
PERFORMANCE BONDS and the granting of:
-+-GRANT FINAL PROJECT APPROVAL
GAANT PROJECT APPROVALIWITH CONDITIONS NOTED
Copy of CONDITIONS given to owner/contractor by inspector
1
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
ci Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Si
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
TV)
SETBACKS ....................
FOUNDATIONt
Footing
Wall.................
PlerlPorch .................
Retaining Wall ...........
Slab Insulation
PLUMBING:
Underground .............
Rough -in
Commercial Final
HEATING:
Gas Test ............
Gas Piping .................
Equipment ... ..............
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ....................
FIRST FLOOR FRAMING
INSULATION ....................
Floor Insulation
Wall Insulation
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ...............
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