20020341.pdfRECEIVED
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CITY OF EDMONDS
C CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINES
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NAME
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ADDRESS
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Plumbing
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Mechanical
THIS PERMIT AUTHORGlia ONLY THE WORK NOTED. THIS PE MIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRU= ON THE PUBLIC
Grading
Recording Fee
D MADQUEED'ETC.)MUR U
OMAIN (CURBS, SIDEWALKS. DRIVEWAYS, ED [RE
SEPARATEPIMUMSSION.
Engr. Review
City Surcharge
PE 1111TAPPIUCAIRON: INDAYS
PERM" 11111HE I YEAR - PROVID D WORK IS STARTED WITHIN I's DAYS
Engr. Inspection
State Surcharge
See BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICANT ON BEHALF OF His OR HER SPOUSE, HEIRS. ASSIGNS AMD SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS ' WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
—
Fire Review
Receipt III
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARIS No DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMU. ISSUANCE OF THI PERMIT SHALL NOT BE
Fire Inspection
Total Amount Due
DEEMED TO MODIFY: WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Landscapoinsp.
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
It
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 CONSTRUC.
CALL
applicatio. Is not, pentri—fil signed by Me
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
SupThis
dingOH Deputy: end ROB all Paid, end
nueo�diil or his1her
P11—k—lod9nditeniteep—ld",
WORKMEN'S COMPEN=RANCE AND RCW 18.27,
OF]ECIALS SIGNAT DATE
'SIGPRE (OWNEMGE OA;
7774
(425)
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71 11-11.11M
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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-
ORIGINM_-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 .........
'FOUNUATIOW
Footing......................
wall
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Pier/Porch .................
Retaining Wall
Slab Insulation
PLUMBING:
M
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M
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0
Rough -in ...................
Commercial Final
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HEATING:
Gas Test
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Gas Piping .................
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Equipment
X
M
Commercial Final
M
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0
EXTERIOR SHEATHING
0
NAILING ..........................
ca,
M 0
FRAMING ........................
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FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation
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Ceiling Insulation
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SHEETROCK NAILING
171
SPECIAL INSPECTION
MISCELLANEOUS
..........
FINAL APPROVAL FOR
OCCUPANCY ..................