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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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I: BE DONEON PRIVATE P OPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Recording/F.0
Grading
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
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SEPARATE PERMISSION.]
L_ . Engr. Review City Surcharge
PER 'TAPPUCATION; IN DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 1. DAYS Engr. Inspection State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPUCA . ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Deposit
IN IN�JZREST, 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, ARISING DIRECTLY OR INDIRECTLY
FROM TH ISSUANC OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE At D
Total Amou us
0 EMED TO MODIFY. IVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Fire Inspection
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* NOR LIMIT IN ANY WAY THE DAYS ABILITY TO ENFORCE ANY 0 __711eceipt #
Landscape AS
HEREBY ACKNOWLE GE THAT I HAVE HEAD TIIIS APPLICATION: THAT THE INFORMATI N APPLI CATION APPROVAL
GIVEN IS CORRECT;AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENI OF
T E OWNER. I AGREE TO COMPLY WITH CITY A14D STATE LAWS REGULATING CONSTH 0 T nat.p" .01 .19..d by IhA
CALL
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TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE SLIP ��g Or.cij., bj�jh., PI.,,: .�d F p1d. -d
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IN VIOLATION OF THE LABOR ODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION piftd.
III WORKMEN'S C,9MMSAT ON INSURANCE AND RCVJ 18.27� DATE
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OFFICLL RF
SIG NATUI 11 1 DATE SIG14ED (425) )�l
RELEASED BY
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ATTE EXT 1333
T'ON
ILAWIUL TOTE R 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
10/01
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS
FOUNDATION:
F0669 ..............
Wall...........................
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Pier/Porch .. ...............
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .......... ..
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0
Rough -in ...................
0
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Commercial Final
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HEATING:
Gas Test ............
Gas Piping .............
Equipment .................
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Commercial Final
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EXTERIOR SHEATHING
0
0
NAILING ................
a be,
FRAMING ........................
IT! 0
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FIRST FLOOR FRAMING
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INSULATION ...................
Floor Insulation
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Wall Insulation ...........
Coiling Insulation
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0
SHEETROCK NAILING
0
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..............