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FEE Description FEE
'an Check
Plan Check
HEAT SOURCE BLAZING 11, LOT SLOPE %
Building
PLAN CHECK NO: VESTED DATE
Plum Ding
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I JOHONTHEP=TO
h BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUSUC
Grading
Recording Fee
DOMAIN (CUROS, SIDEWALKS. DRIVEWAYS, UAROUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
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Engr, Review
City Surcharge
PER MAPPLICATION: IN DAYS
PERMIT UM : I YEAR - PROVIDED WORK IS STARTED WITHIN 1. DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS ASSIGNS AND SUCCESOFIS
Traffic Mitigation
Plan Chit Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, SHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS 11R.. ANY AND
WA
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY 08 INDIRECTLY
FROM THE ISSUANC OF THIS PERMIT. ISSUANCE OF THIS EIGHT $HALL NOT BE
In P CE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREME OF ANY CITY ORDINAN
Fire Inspection
Total Amount Due
0 NOR LIMIT IN ANY WAY THE CITYS ABIUTY TO ENFORCE ANY ORDINANCE PROVISION
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Receipt # A�
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I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
0,
UC
THEOWNER. AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONST. .
FiTRYUEC
CALL
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TION; AND IN DOING THE WORK AUTHICRI ED THEREBY. NO PERSON WILL BE EM D
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTION Wpl 1. d.kd.wl.d,.d in �p ... p—IdId.
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771-0220
RELEASED V
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-
ORIG NAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER - GOLD - ASSESSOR
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FINAL,,PROJECT APPROVAL -FORM
TO: -
DATE:_
MEMOTO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: /;A -FIRE DEPARTMENT DATE
-ENGINEERING DIVISION DATE -
PLANNING DIVISION DATE -
PROJECT 6;, e,l U-sr
SITE ADDRESS 2a--If 2- 411
PERMIT 0�2g ADB#_______PATE INSPECTED-S&-LCZCL�
DESCRIPTION OF WORK TO BE INSPECTED-C)SE
A field I 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
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date- Sign_
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RECORD OF INSPECTIONS
INSPECTOR
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DATE APPROVED
SETBACKS ...........
FOUNDATION:
Footing ......................
wait _ ..............
PlerlPorch .................
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground
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Rough -in ...............
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Commercial Final
HEATING:
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Gas PIP ... ...........
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Equipment
Commercial Final
EXTERIOR SHEATHING
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NAILING ...................
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'FRAMING ........................
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FIRST FLOOR FRAMING_
Q 0
i INSULATION ...................
Floor Insulation
Wall Insulation
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ...........