20020414.pdfDATE RECEIVED
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PERMIT EXPIRES
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CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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REMARKS
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Description
FEE
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Plan Check
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uilding
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THIS PERMIT AUTHORMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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t: BE DOME ON PRIWXrE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU LIC
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Grading
Recording Fee
ooMmN (cunas, SIDEWALKS, DRIVEWAYS MAROU ES. ETC.) WILL REQUIRE
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SEPARATE PERM;SSION.
Engr. Review
City Surcharge
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PE MarAPPLICATION: 180.
PERMIT LHUM 1 YEAR - PROVID D WORK 15 STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
State Surcharge
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-APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFI. DEFEND AND HOLD HARMLESS THE CITY OF
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Receipt #
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY On INDIRECTLY
Fire Review
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Fire Inspection
Total Amount Due
DEEMED TO MODIFY. WA VE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CIWS ABILITY TO ENFORCE ANY ORDIN E PROVISION.
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Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION
APPROVAL
GIVE IS CORRECr, AND T14AT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMP WITH CITY AND STATE LAWS REGULATING CONSTRUC�
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TION; AND IN DOING TH WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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WORKMEN$ COMPENSAT
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CI SIGNA E DATE
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iTION
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771-0220
PFATE
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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-
ORIGINAL -FILE YEuLow-tWsPE6ToR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER - GOLD -ASSESSOR
10101
LOT LINE STAKES MUST
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FOUNDATION INSPECTION
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
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SETBACKS ....................
FOUNDATION:
Footing ..........
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Pier/Parch
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Retaining Wall
Stab Insulation
PLUMBING:
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Underground .............
In
C a
Rough -In ............
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0
Commercial Final
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HEATING:
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Gas Test ...............
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Gas Piping ................
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Equipment
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Cornmercial Final
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EXTERIOR SHEATHING
NAILING ...................
0
0
C
FRAMING ......................
Q 0
FIRST FLOOR FRAMING
INSULATION .............
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
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