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PERMITEXPIRES
CITY OF EDMONDS
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REPAIR GRADING CYDS El I _X_FT) REMARKS
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DESCRIBE WORK TO BE DONE
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Description
FEE Description FEE
Plan Check
State Surcharge
HEAT SOURCE
LOT SLOPE %
Building Permit
City Surcharge
PLAN CHECK NO: ;TED DATE
Plumbing
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
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- �1
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUSLI
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MAIN
Grading
3 (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
t SEPARATE PERMISSION,
2
PERMITAPPLICAXION; INDAYS
Engr. Review
PERMIT LIMIT. I YEAR- PROVIDE WORK IS STARTED WGmIN 180DAYS
Engr. Inspection
_SEE BACK OF PINK PERDMIT FOR MORE INFORMATION
'APPLICANT, ON SE14ALI OF HIS OR HER SPOUSE, HEIRS ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt 11
A L CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR HE UCE ANY REOUIhEMEMT OF ANY CITY ORDINANCE
Landscape Insp.
LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION..
Recording Fee
HENOR
REDY ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT,AND THAT
APPLICATION APPROVAL
M
A THE OWNER. OR THE DULY AUTHOR ZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
INS ppH.U.S, IS n0l a F-4 unfil signad by tho
TION; AND IN DOING THE WORK AUTHORIZED THEREBY NO PERSON WILL BE EMPLOYED
V
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JIN IOL&TION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMENS COMPENSATI�NINSURANCE AND RCW H.27.
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FOR INSPECTI N
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NATURE (OWNER Or,/AGENR LATE IONED
(426)
OFF] IAL SIG ATURE DATE
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(9 421ZQ��
771-0220
DATE
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
6/1/"'/1
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL-FILF YELLM.-�HSPECTR
PINK - OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN - ACCOUNTING
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RECORD OF INSPECTIONS
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INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall ..........................
Pier/Porch ................
Retaining Wall ...........
4
Slab Insulation ..........
PLUMBING:
Underground .............
0 M
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Rough -in
M
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Commercial Final
M
HEATING:
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Gas Test ...............
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Gas Piping
Equipment ................
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3.
Commercial Final
ITI M
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 ...........
Ceiling Insulation
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SHEETAOCK NAILING
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SPECIAL INSPECTION
In
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..............
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