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PERMIT ExPIRES
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CONSTRUCTION PERMIT APPLICATION
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PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REOD
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Description
FEE Description FEE
Plan Check
State Surcharge
HEAT SOURCE GLAZING %
LOT SLOPE %
Building Permit
City Surcharge
PLAN CHECK NO
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Plumbing
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THIS PERMIT AUTHORIZES
Mechanical
ONLV THE WORK NOTED. THIS PE RmmCOvEFSwoRKT0
B DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCT.. ..THE PUBLI C
DOMAIN (CURBS. SIDEWALKS.DRIVEWAYS MARQUEES, SM.) WILL REQUIRE Grading
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SEPARATEPERM; SSION.
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Engr. Review
PERdd.LdddT,Y P.R.ITAPP.CATION 1. a
EAR, PROVIDED WORK IS STARTED WITHIN UHIMAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLIC W. ON BEHALF F His OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORE
Fire Review
PlanChk.Deposh
IN INTEREST, AGREES TO IN EMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FO
Fire Inspection
Receipt III
DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF IHIS PERMIT SHALL NOT E
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DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANG E
I I ANY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PFIOWSION.'
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Recording Fee
Total
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HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE JNrOSMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TIGIL AND
CALL
Thin appiftatio, Is—, P111d ',in signed by din
IN DOING THE WORK AUTHORIZED THEBEBY. NO PERSON WILL BE INIPLOYED
IN VIOLATION OF THE
Irnd,ng Oftni o, hin1h., Dbrndy: ..0 F in ridd, rd
LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
W SATION INSURANCE AND RCW 18,27�
FOR INSPECTION
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RELEASE. BY DAfE
ATTENTION
EXT 1333
IT
IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A
FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION log
ORIGINAL - FILE YELLOW - INSPECTOR
04/02 PRESS HARD -YOU ARE
MAKING 5 COPIES
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FINAL PROJECT APPROVAL FORM
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DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
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PLANNING DIVISION DATE -
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A field inspection was conducted to determine final compliance rith approved plans. Finalupproval
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denotes that there are no objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of:
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign_
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RECORD OF INSPECTIONS
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INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ........... .......... .
Wall ..........
Pier/Porch ............
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Retaining Will ..........
Slab Insulation
PLUMBING:
Underground .............
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Rough -In ...................
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Commercial Final
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FIRST FLOOR FRAMING
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INSULATION . ............
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Floor Insulation
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Wait Insulation
Coiling Insulation
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SHEFTROCK NAILING
SPECIAL INSPECTION
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