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I I -PERMIT
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CITY OF EDMONDS
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CONSTRUCTION PERMIT APPUCATION
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REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLA)RAINAGE
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REQUIRED SETBACKS (FT.) PROPOSED
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SETBACKS (FT)
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PLANNING REVIEWED BY DATE
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REMARKS
OTHER
DEMOLISH 0 TANK
o GARAGE 0 RETAINING WALL
ARPORT ROOKERY RENEWAL
UWE OF USE. SUSINST an ACTIVITY) EXPLAIN:
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REMARKS
PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION RE42D
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Description
FIfE
Description
FEE
Plan Check
HEAT SOURCE GLAZING LOT SLOPE
Building
Plumbing
PLAN CHECK NO-
Mechanical
THIS PERMIT AUTHORM PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUSUC
Gote" (CURBS'SIGEWALIC1. DRIVEWAYS MAROU ES, ETC.) WILL REQUIRE
SS.PERM;SSIOsL E
Grading
Recording Fee
Engr. Review
City Surcharge
PER TFAPPLICATION; Iri
PERMIT Led . I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
State Surcharge
Traffic Mitigation
Plan Chk Deposit
19 'APPLICAN7, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, A89IGNS AND SUCCESORS
E
19 IN INTE EST. AGREES TO INDEMNIFY DEFEND AND HOLD HARML SS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS MOM ANY AND
Fire Review
Receipt #
DIRECTLY 0"'NDRFCT'y
ES OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT 'BE
-
DEEMED TO MODIFYYWAIVE OR REDU E ANY REQUIREMENT OF ANY CITY ORDINANCE
0 R -S'ON
MNCJ
NORLIMITINANYW THE CHYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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Fire Inspection
D Us
Landscapoinsp.
IHERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
N T,
Nr
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
TION; AND INDOINGTH WORK AUTHORIZED THEREBY NO PERSON WILL BE EMSTRUC
E RSON WILL BE EMPLOYED
LA
IN VIOLATION OF THE LA8" CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMENS COMPENSATION ItNIE AND 1ICW 18,11, 1
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SIGNATURE ATE SIGNED
APPLICATION APPROVAL
This appIlornion Is not a
CALL P
SWdloo 01116.1., his ho, -oti
FOR INSPECTION .. P—Idnl.
0,,,C DATE
(425) 2-
2,
��ATUII 61
771-022U REL EL* DATE
ATTENTION
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 109
EXT 1333
771-0221
ORIGINAL -FILE YELLOW-INSPE04B
FAX PINK - OWNER GOLD - ASSESSOR
10/01
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RECORD OF INSPECTIONS,
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION;
Footing ......................
Wall.. ........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
x
M
Rough -in .............
,
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M 0
Commercial Final
0.
HEATING:
M
GasTest ....................
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Gas Piping .................
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Equipment ..............
Commercial Final
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EXTERIOR SHEATHING
IT, M
NAILING ..........................
0
OR
FRAMING ................
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FIRST FLOOR FRAMING...
ITI 0
INSULATION ............
�Fipor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
0
ITI
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY
oC,
..................