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CONSTRUCTION PERMIT APPLICATION JOB
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REMARKS
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PROPERTY TAX ACCOUNT PARCEL NO, COMPLETE , EXEMPT
LOT C VERAGE
[3 NEW RESIDENTIAL LUMB�A�G'��
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS JFT)
ALLOWED PROPOSED
FRONT SIDE HEAR
FRONT UASIDE REAR
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AREA PLANNING REVIEWED
BY DATE
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REPAIR GRADING eyes E] PENCE F.)
REMARKS
0 DEMQU$H TANK
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as CARPORT U ROOKERY
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OGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REOD
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VALUATION $
D Description
FEE Description
FEE
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Plan Check
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PLAN CHECK NO: 3TED
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Mechanical
THIS PETUIRT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORKTO
t: BE DONE ON PRIVATE PROPERTY ONUX ANY CONSTRUCTION ON THE PUBUC
2
Grading
Recording Fee
a ONUUM (CURBSI, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMiSSION.
PE MITAPPLICATIGN: 180DAYS —
Engr. Review
City Surcharge
PERMIT UMPE I YEAR-PROVI ED WORK IS STARTED WITHIN In DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR PADRE INFORMATION
ON 11-IF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CI OF
EDMONDS, WASHINGTON, IT$ OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS P11U1. ISSUANCE 01 THIS PERMIT 1.11 NOT BE
DEEMED TO MOU WAIVE REQUIREMENT
Fire Inspection
TotalAmountDue
. OR REDUCE ANY OF ANY CITY ORDINANCE
Noll LIMIT IN ANY WAY rdE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapelnsp.
Receipt Its
I HEREBY ACKNOWLEDGE THAT I HAVE READ TH S APPLICATION; THAT THE INFORMATION
IE
APIP ICATION APPROVAL
GIVEN IS CORRECT, AND THAT AM T14E OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. [AGREE TO Cc PLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This appfi�"I.h 11 a.'. Ineaft.ofil aligned L, ..
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STAT . OF WASHINGTON RELATING TO
FOR INSPECTION
B,I!ding Chfiehd or his/her Doply: and Fees are paid, and
,c,lpti$4cR,olodg,di,spa�wovided.
WORKMENS COMPENSAT19P-WWNCE AND RCW 18,27.
OFFICI
DATE
[IATI SIGNED
(425)
511!5
771 -0220
77TENTION I /
EXT 1333
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
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...............
FOUNDATION:
...........
Wall ..................
Pier/Porch .................
Retaining Wall ..........
M
Slab Insulation ..........
4 -11
PLUMBING:
IT
Underground
M
Rough
0 C
-In
Commercial Final
ITI 171
HEATING:
>
Gas Test ..............
Gas Piping I ..........
0 -n
Equipment .................
M ITI
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
V)
Q 0
FRAMING ........................
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FIRST FLOOR FRAMING
;D
INSULATION ...................
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Floor Insulation
Wall Insulation ...........
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Coiling Insulation
SHEETROCK NAILING
IT
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
C,
OCCUPANCY ....... . .....
C 0 0