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CONSTRUCTION PERMIT APPLICATION
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
L BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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DOMAIN ICURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.1 WILL REG IRE
GRADINGIFILL
SEPARATE PERMISSION . ....... .
STATE SURCHARGE
PE MIT APPLICATION: ISO DAYS
PERMIT LIMIT.- I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG� REVIEW FEES
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
END INSPECTION FEE
;APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Y. DEFEND AND HOLD HARMLESS THE
N INTEREST. AGREES TO INDEMNIF ROM CITY OF
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS F IN ANY AND
ALL CLAIMS FOR OAMAGESOF WHATEVER NATURE, ARISING DIRECTLY OR DIRECTLY
LANDSCAP NO
INSPECTION FEE
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
DEEMED T=FY. WAIVE OR EDUCE ANY REOUtREMENTOF ANY CITY ORDINANCE
-1 NOR LIMIT WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
TOTAL AMOUNT DUE
I HERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMP DYED
IN VIOLATION OF THE LABOR ODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTI(
WORKMEN=SATION I SURANCE AND RCW 18.27.
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SIGN7% 1Hl SIGNED
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7 71-0220
ATTENTION U
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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, USC SECTION 109
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...................
FOUNDATION:
1 Footing ......................
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wall..........................
PlerlPorch .................
0
Retaining Wall
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Slab Insulation ..........
PLUMBING:
C
m
0
.............
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0 C
Rough MS
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3:
-in ..........
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Commercial Final
HEATING:
GasTest ....................
0 -n
Gas Piping .................
ITI 171
Equipment ...........
Commercial Final
0
0 Fn
EXTERIOR SHEATHING
NAILING ..........................
Q 0.
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FRAMING ...........
FIRST FLOOR FRAMING
INSULATION ...................
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2
Floor Insulation
ca
Will insulation ...........
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Ceiling Insulation
171
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ...............