20020483.pdfDATE RECEIVED PERMIT EXPIRES
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CITY OF EDMONDS NUMBER711)2 �57
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UBC
INSPECTION REaD
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Description FEE Description FEE
'Ian Check State Surcharge
GlUkUNG % LOT SLOPE % Building Permit City Surcharge
PLAN CHECK NO: Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE I Fall PROPERTY 1"Ll. All 1"11111*" 1" THE 11 I'D IT
da a Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS RRE
SEPARATE PERM; MARQUEES, FTC�) WILL FIEQUJIR
SSION
Engr. Review
PE"MITAPPLICATI N: I80DAYS
PERMIT Limit. I YFARV . PROVI ED WORK IS STARTED WITHIN '80 DAYS
Engr. Inspection
SEERACK0 PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chill. Deposit
I. INTERESI ncIRECS TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DA NATURE, AR SING DIRECT LY OR INDIRECTLY
MAGESOF-HATEVER
FROM THE ISSUANCE OF THIS PERMIT SSUANCC OF THIS PERMIT SHALL NOT BE
I M ORDINANCE
DEEMED TO MODIFY. WAIVE OR REOU E ANY REQUIREMENT OF ANY C
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Total Amt. Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
Recording Fee
Receipt ly
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPUCNnON; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
a application 1. nod. plondt.Mil algoad by in.
TIO N; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LADD CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Bourn
ding Official a, Nadia, Dep,dy: and Ftnia aid paid. and
WORKMENS COM_PENSAT�"RURAN E AND RCW 18.27.
OFIICIALS SIBNATVRF DATE
SIG
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771-0220
RE1EAS_ED
By f/ I DiTt
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-
ORIGINAL - FILE YELLOW - INSPECT A
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
PINK � OWNER GOUD,ASSESSOR
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
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ENGINEERING DIVISION DATE
PLANNING DIVISION DATE
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denotes that there are no objections from the above signed Department to the release of
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...............
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EXTERIOR SHEATHING
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NAILING .................
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FRAMING ........................
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INSULATION ...................
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
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OCCUPANCY ...... ........