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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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NAME
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PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
GOADINGWILL
21 DOMAIN (CURBS, SIDEWALSKCSFADRRAITVCEWAYS, MAROUEES, ETC,3 WILL REOUIRE
: i PERMISSION.
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U.TqRCHARGE
PERMIT APPIEICATION� 180 DAYS
P.B.ITLIMIII YEAR -PROVIDED WORK IS STARTEOWiTHIN HWDAY$
ENG, REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT, ON BEIFALF.F HIS OR HER SPOUSE. ITEMS. ASSIGNS AND FUCCESOBE
END, INSPECTION FEE
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD ARMLESS THE CITY 01
2 EDMONDS, WASHINGTON, iTSOFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
INSPECTION FEE
ALLCLAIMS FOR DAMAG9SOlWHATEVER NATURE, ARISING DIREC -O."'DIRECTLY
RECEIPT
FIT M THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERM T SHALL NOT BE
DEEMED 10 MODIFY. WAIVE OR REDUCE AN' REOUIREMENI OF A14Y ITYCADII,JANCE
PLAN CHECK DEPOSIT
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0 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Eat
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLIIATIGN. THAT 'HE INFORMATION
APPLICATION APPROVAL
GIVEN I CORRECT, AND T AT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
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THEOWNER AGREE TO COMPLY WIT. CITY AND STATE LAW' REGULATING CONS rRUC,
TION. AND IN DOING THE WORK AUTHORIZED T.EREOY, NO PE RSON WILL BE EMPLOYED
CALL
S.
IN VIOLATI N OF THE go QDE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Won�MENIOSCOMIPENgkIA10�ik�U)ANCE AND RCW 18,27
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771-0220
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IT DATF
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EXT 333
IT IS UNLAWFUL TO USE OR 04�PY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL FILE - YELLOW INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
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FINAL PROJECT APEROVAL FORM
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MEMOTO: PEP2&r COORDINATOR, BUILDING DIVISION
FROM: ----YIRE DEPARTMENT DATE
ENGINEERING DIVISION DATE
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PLANNING DIVISION DATE
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PERMIT 2,,Qn 2, -0 LQ� -2 ADBk--DATE INSPECTED
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DESCRIPTION OF WORK TO BE INSPECTED—"
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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
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LEPFORMANCE BONDS and the granting of:
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FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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a Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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a Copy of CORRECTION NOTICE given to owner/contractor by inspector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Si
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(7)
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing...................
Wall ................
Pier/Porch .. ...............
Retainlrig Wall ...........
Slab Insulation ..........
PLUMBING:
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Underground .............
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Rough -in
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Commercial Final
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HEATING:
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Gas Test ..............
Gas Piping ..................
Equipment
.................
Final
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Commercial
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EXTERIOR SHEATHING
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NAILING ........... ..............
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FRAMING ........................
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FIRST FLOOR FRAMING
INSULATION ..................
Floor insulation
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Wall Insulation
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Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ................