20020398 (2).pdfI`
DATE RECEIVED '- � o PERMIT EXPIRES 111361
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I UiE PERMIT -
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ADDRESS REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
CITY ZIP ILIPHONE
NAME
121 ENGINEERING REVIEWEDIDAIE
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N�.STATE LICENSE NUMBER EXPIRATION By VARIANCE OR CU �O.IIINE OR ADS# INFL��C�10N
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VALUATION $
Description
FEE Description
FEE
Plan Check
LOT SLOPE %
Building
PLAN CHECK NO: rED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERM" COVER WORKTO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
Recording Fee
00"N (CURDS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMiSSION.
2-
Engr. Review
City Surcharge
RE MITAPPILICATIOW. INDAYS
'11952
PERMIT LIMM I YEAFI - PROVIDED IN RK IS STARTED WITHIN 140 DAYS
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON 11HAU101 HIS 01 HE" 1POU11, HEIIII, ASSIGNS AND SUICE1011
Traffic Mitigation
Plan Chk Deposit
10 INTEREST, AGREES To INDEIIIIII, DEIENII AND "DID IIAIIMLIsl IN, ,,, OF
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt III
If ZiO
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARIS NO DIRECTLY OR INDIRECTLY
FRO THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE
Fire inspection
Total A
DEEMED TO MODIFY� WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CIWS Am TO ENFORCE ANY ORDINANC PROVISION.-
EN I AN NA E N'
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Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THMAT THE INFORMATION
ON
APPLICATION APPROVAL
-N'Z�D A -ENT
GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE DIANE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATIN -
TY AN a 'IN. CONST-U
BECEOINSLT(RUC
CALL
T"-PPIK.'" 1, no � P-4 LrOl,ignel by Ih.
S . ILL BE EMPLOYED
N; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL D
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To
LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
IN VIOLATION,Q E ET T " To REL TIN G
Buildi-9 01116M.1 hKlh�l F--
FOR INSPECTION '_01 1, ��kn—I.dq�� J—p ...
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WORKMENT/,180 �NSATION INSURANCE AND ACW 10,27.
1AI! S
DATE
O"EPJOR AGENT) DATE SIGNED
(425)
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NIN
771-0220 RELEASED DATt
BY
ATTENTION
EXT 1333
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
�F'
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI�
ORIGINAL - FILE "I-41-LOW -
WSPECTO
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...................
FOUNDATION:
Footing......................
Wall ..........................
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Pier/Porch ................
Retaining Wall ...........
0
Slab Insulation ..........
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PLUMBING:
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0
Underground .............
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Rough -In ...............
0
Commercial Final ......
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HEATING:
0
GasTest ....................
Gas Piping ..........
0 -n
Equipment.............
Commercial Final
M M
EXTERIOR SHEATHING
0
NAILING .............. ; ...........
0
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FRAMING
M 0
FIRST FLOOR FRAMING
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INSULATION ; ..................
Floo r Insulation
Wall Insulation
Ca
Ceiling Insulation
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SHEETROCK NAILING
0
SPECIAL INSPECTION
IT1
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .............