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PERMIT EXPIRES
CITY OF EDMONDS ERM T
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CONSTRUCTION PERMIT APPLICATION JOB EBB IUITIIAPTI
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THIS PERMIT ALT ORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC
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Recording Fee
DOMAIN (CUR'S'SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
3 SEPARATE PERMISSION.
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Engr. Review
11�3 � __
City Surcharge
PERUITAPPLICATION: INDAYS
PERMATUMITI . PROVID WORK IS STARTED WITHIN ISODAYS
SEE RACK OiPINK PERMIT MR MORE INFORMATION
Engr, Inspection
State Surcharge
ON BEHiUJ`OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND IUCCIIORI
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY DEFEND AND ..to A..LESS THE CITY OF
1111IONDS, WASHINGTON, ITS O11ICIAL1, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
"IBM THE I11UA C' 'IF THIS PERMIT, ISSUANCE 01 THIS PERMIT SHALL NOT BE
Fire Inspection
Total Amount
DEEMED TO MODI�, WAIVE OR REDUCE A Y REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
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Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIOI,L THAT THE INFORMATION
GIVEN 16 CORRFCT� AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
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TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATIO�XJE LA OR CODE OF THE STATE OF WASHINGTON RELATING TO
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WORKMEN'S e SATION INSURANCE AND How 18 27�
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771-0220 RELEASED By
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ATTENTION
EX`r 1333 'i_
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
2
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI
ORIGINAL Flt� YELUC
OR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Fooling ............
Wall ....................
Piet/Porch .................
z
86taining Wall ...........
0
Slab Insulation ..........
PLUMBING:
c:
Underground .............
M
Rough
IT!
-'In . ..................
0
0
Commercial Final
C
HEATING:
R11
ITI
GasTest ....................
>
E:
as PIpIn g .....
Equipment ..............
Commercial Final
1111 ITI
EXTERIOR SHEATHING
a
NAILING .................
FRAMING
0
0
C
V)
0
FIRST FLOOR FRAMING
INSULATION ... ................
Floor Insulation
z
Wall Insulation ...........
Ceiling Insulation
ca
z
SHEETROCK NAILING
SPECIAL INSPECTION
0
IT!
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ................