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PERMIT EXPIRES
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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ALLOWED PROPOSED
FRONT SIDE HEAR
FRONT URSIDE HEAR
0 CHANGE OF USE
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PLANNING REVIEWED By DATE
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NPROGRESS INSPECTIONS PER USC 10111FINAL INSPECTION REOD
VALUATION $ -45
DeaCriprillo, FEE Descriptlon I FEE
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Plan Check
P HESSWRCE LCITSLOPE%!�
t: THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO echanical
a BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CURBS, SpEwALHS' DRIVEWAYS, MARQUEES. ETC,) WILL REQUIRE
SEPARATEPERMISSIDN.
2 -- Engr, Review
Recording Fee
City Surcharge
5
PE MITAPPLICATION: 180DAYS
PERMIT LUMB I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
Sea 0
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
State Surcharge
Plan Chk Deposit
41
'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS AS811INS AND SUCCESORS Traffic Mitigation
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HO�o HARML--- -
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Review
I ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
9 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE Fire Inspection
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
Receipt #
q�'01
Total Amount Due
eipt #
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I HERSBY ACKNOWLEDGE THAT I HAVE HEALD 7H S APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNEIA, Oft THE DULY AUTHOR ZED AGENT OF
THE OWNER . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC, CALL
TION; AND IN DOING THE WORK AUTH RIZED THEREBY, NO PERSON WILL BE EMPLOYED
N OF THE
APPLICATION
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IN V14 0 LAUD Cool 01 THE STATE 01 WASHINGTON IE-114G TO FOR INSPECTION III Ia..ka-[.dg,d I, OF— pfided,
We. 1. COMPENSATIONOSURA,
�CE AND RCW 10.27. (425) GFFIC1IGN3A,', DATE
DATE SIGNED ie
ij
771-0220 SED ATE
�"AIY
BE OR OCCUPY A BUILDING OR STRUCTURE UNTIL EXT 1333
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 ORIGINAL - FILE YELLOW *INSPECOR
10101 FAX PINK - OWNER GOLD - ASSESSOR
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DEPARTMENT OF BUILDINGS
ON 109
PER UNIFORM BUILDING CODE SECTI
uIlding Permit #: #2002-0401,,,
98026
7907 21P St-1 SW. Suite 209 Edmonds VIA
At:
its: -N/W* No. Stories:
Occupancy established by this cartificat8' �Owelling Un
g Ur
Ty , 0 -1 hour Basement: No
Type Construction. V
B p
(Per u.B.C. 1002)
Maximum occupant Load -4-
Room capacity signs, ZWn mqukd, must remain posted at all times.
I � I '1' 1 Suli a , 01' 1 Ei monds, WA 9802
Owner of Building.... M —���ING WITH THE REQUIREMENTS Ur I
Ichell Co _�structjonlnc. Address: 79072 211 z1het'.
iiD I�
Ist HAS BEEN INSPEC III) Al
THE K. zimmerman P�s hotheM
�M yc�ltl� AND DIVISION OF OCCUPANCY AND THE USE
rTin_�
)ITION OF THE UNIFORM BUILDING CODE AS ADOPTED By THE CITY FOR THE GROUP
1997 El
FOR WHICH THE PROPOSED OCCUPANCY IS CLASSIFIED.
18th day of_jq_ne 2002
issued this
CHIEF BUILDING OFFICIAL
SY: building P-nn'ttind.
Thle eartifidatelifalil be abated In. —pl.., pubbe d—lad.hall net be nada.�. _111.td a, ahall be -lahlad In at all deals. Mychaelisel—bilin,.—aneple,
Cadir,ante of oetuidanq 1.,lad bY Me QtVf Ed—ca, Wilding Officint,
E2
FINAL PROJECT APPROVAL FORM
TO:—
DATE: —
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
F ROM: —FIRE DEPARTMENT DATE
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE —
PROJECT
SITE ADDRESS__Vz9 2
PERMIT #A�P,2— -/-�ADB#
INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
c3 Copy of CONDITIONS given to owner/contractor by inspector
1
FAILED FINAL INSPECTION -OUTSTANDING ISSUES
u 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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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
Wall ....................
PlerlPorch . ................
Retaining Wall ...........
Slab Insulation
PLUMBING:
Underground .............
Rough -In ..................
Commercial Final
HEATING:
Gas Test
Gas Piping .............
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ...........
FRAMING ...........
MIS
--a
FIRST FLOOR FRAMING_
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........