20020370.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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THIS PERMIT AUTHOnIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADMGIPILL
ETC.) WILL RE
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, QUIRE
SEPARATE PERMISSION,
SURCHARGE
PERMIT APPLtCATI N: 180 DAYS
PERMIT LIMIT'. I YEAR . Pft.W. D WORK 1. STARTED WITHIN 10 SAN.
-G. REVIEW FEES
SEE 5AAC. .1 PINK PERMIT FOR MORE INFORMATION
�A P ICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
P L
END, INSPECTION FEE
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
!NSPECTtONLEE
ALLCLAIMS FOR DAMAGESOF WHATEVER NATURE, ARISING 0 RECTLYOn INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANYCITYORDINANCE
PLAN CHECK DEPOSIT
J.-EIPT
6j NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
TOTAL AMOUNT DUE
IFECEIPT
,�._E.y ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
"'N IS CORRECT, AN. THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
T, I AGREE TO COM LY WITH CITY AND STATE LAWS REGU ATING CONSTRUC-
HE OWNER I AGREE TO COM
CALL
1 - 111 U01 �19d �l
T K)N. AND IN DOING THE WORK AUTHORIZED THEREBY, NO IERS NWILLBEEMPLOYED
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II,j VIOLATION OF THE LA on CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION p 11wildgod �l p,d
-MEE;AleNSURAN E AND ACWI8.27.
OFFfCIA LS SIGNATURE 37J�E
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EXT 333
ITISUNLAWFULTO USEOR OCCUPY A BUILDING OR STRUCTUREUNTIL
771-0221
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE - YELLOW- INSPECTOR
GATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
5190
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
�SETBACKS .....................
FOUNDATION:
Footing
Wall ... .......................
Pier/Porch .................
getainlrig Wall
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final
HEATING:
Gas Test ....................
—az
Gas Piping
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING .......... .............
FIRST FLOOR FRAMING
INSULATION ..........
Floor Insulation
Wall Insulation
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
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