20020363.pdfFP-ERMITEXPIRES
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAY , MARQUEES, ETC.) WILL REQUIRE
GRADNOIFILL
SEPARATE PERS
MISSION.
PERMIT APPLICATION; ISODAYS
_5;-nUFG.AfI.E
PERMIT LIMIT., I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK RE MIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
IN NTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAP NG
2 EDMONDS� WASHINGTON� ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
INSPECTION FEE
A L CLAIMS FOS DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIREC BLY
FS M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SH LL NOT BE
PLAN CHECK DEPOSIT
RECEIPT
DEEMEDTOMOCIFY, WAIVE R REDUCE ANY REQUIREMENI OF ANY CITY ORDINANCE
N L E CITY S ABILITY TO ENFORCE ANY ORDINANCE PROVISION'
1810EIPT
M
T ALAMOUNTDUE
I HEREB ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
APPI ICAtION APPROVAL
T EOWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
Th� �p `F ` A I.- I,l -
�h,WhO.P.Iy,
SON. AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LA 'C..;N.' THE STATE OF WASHINGTON RELATING TO
WORKMEN SCOMPENSATPYMUS . AND RCW 18 27�
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FOR INSPECTION
DATE SIG
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RELEA S,
ATTENTION
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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
ORIGINAL - FILE YELLOW INSPECTOR
PINK - OWNER GOLD - ASSESSOR
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FINAI:PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: DEPARTMENT DATE -IS -3 —0- 6 2-
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE —
PROJECT Lr-S- 7— /-r d:� C
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SITE ADDRESS Y,5
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DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine final compliance with Approved plans. Final approval
ase of
denotes that there are no objections from the above signed Department to the rele
PERFORMANCE BQNDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WrIH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractorby inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE_INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date— Sign_
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FOUNDATION:
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Pier/Porch .................
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground .............
RoUgh-In .... ...............
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Commercial Final
HEATING:
Equipment
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ... .....................
:FIRST FLOOR FRAMING
INSULATION ...........
Floor Insulation
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Ceiling Insulation
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