20020350.pdfDATE RECEIVED
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PERMIT EXPIRES
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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NO. 01 11-UREI
PRV REQUIRED
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTRO LIDMINAGE
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LOT COVERAGE
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REQUIRED SETBACKS (Fr.) PROPOSED
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SETBACKS (Fr.)
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'I PLANNING REVIEWED BY DATE
REMARKS
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NUMBER
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REMARKS
PROGRESS INSPECTIONS PER LIBC 1081FINAL INSPECTION REOD
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VALUATION s
FEE
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Plumbing
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THIS PERMIT AUTHORIZES ONLY THE ORKNOTED. THIS PERMIT COVERS WORK TO
Mechanical
1: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON EPUB
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Grading
Recording Fee
3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETCJ WI_" AEOUILRICE
L SEPARATE PERMISSION.
Engr. Review
City Surcharge
PERMITAPPLICATI N: ISDDAYS
PERMIT EJMrr. I YEAR-PROVI ED WORK IS STARTED WITHIN 'M DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-IUCANr, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREED TO IND MNI1. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
Fire Review
—
Receipt #
FROM THE ISSUANCE OF THIS PERMIT ISSUANCi OF THIS PERMIT SHALL NOT 81
Fire Inspection
Total Amount Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT 07ANY CITY ORDINANC
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION-
as
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Receipt #
I HERSSY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPRWAL
THE OWNER. I AGREE TO COMP WITH CITY AND STATE LAWS REGULATING CONSTRUC�
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
T PI cation Is not a ponaft vote signed by 0
fhAkehjg2`d1s�.1 ., hien., Dp.1y: and Food— Pat
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
IPE I, ack-1,ditod 1, space rawided,
I WORKMENSP90PERSATIONIN
,YRANC� AND RCW 18,27.
OF DATE
DATE SIGNED
(425)
771 -0220
'RELEASED
BY DATE
ATTeNY1ON 4�
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER - GOID�ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ..............
z
wait ................
Z5
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
M
tj
PLUMBING:
iJI,
IR 0:
0
Underground .............
C
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Rough ...................
3: M
ITI
Commercial Final
C z
HEATING:
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Gas Test ...........
0 -n
n La
Gas Piping .. ...............
M M
Equipment ...........
Commercial Final
6 Fn
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EXTERIOR SHEATHING
0)
0
NAILING .., .......................
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FRAMING .....................
;a
FIRST FLOOR FRAMING
INSULATION ...................
>
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Floor Insulation
0)
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Wall Insulation ...........
Ceiling Insulation
0
M
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..............