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PERMIT EXPIRES
CITY OF EDMONDS
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PERMIT
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CONSTRUCTION PERMIT APPLICATION
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ADDRESS REMARKS
OWNERICONTRACCOR RESPONSIBLE FOR EROSION CONTROUDRAINAGI!
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REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REOD
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VALUATION
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Description
FEE
Description
FEE
Plan Check
State Surcharge
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Building Permit
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city Surcharge
PLAN CHECK NO:
STED DATE Plumbing
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVEHSWOnKTO
t: BE DONE ON PRIVATE PROPERTY OH- ANY COMM CTIONONTHEPUeUC
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S DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES. ETC.) WILL REQUIRE
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SEPAqAT EPERM;SSIONL
PE M17APPLICATION: INDAYS
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Engr. Review
PERUITUNIM. I YEAR -PHOVID D WORK IS STARTED WITHIN L40OAYS
Engr, Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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*APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire
Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARM EBB THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIAL S, EMPLOYEES. AND AGENIE FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT HE
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Total Amt. Due
DEEMED TO MODIFY, OR REDUCE ANY REQUIREMENT OF ANY CI FY ORDINANCE
WAIVE
NOR LIMIT IN ANY WAY THE ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
DRYS
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Recording Fee
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
AP P
L CATION APPROVAL
11
GIVEN 15 CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
CONSTRUC-
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THE OWNER. I AGRE TO COMPLY WITH CITY AND STATE LAWS REGULATING
PERSON WILL BE EMPLOYED
CALL
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THE WORK AUTHORIZED THEREBY, NO
TION: AND in DOING'
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTiON1
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WORKMEN'S COMPENSAT12a-LNSURANCE AND ACW 10.27.
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SIGNATURE (OWNER C(AGEO
—1 SIGNED
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771-0220
T
fEk,,( DATE
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTH
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...............
FOUNDATION:
Footing
Wall.......... ...............
Pler/Porch .................
Retaining Wall ...........
Stab Insulation ..........
PLUMBING:
Underground .............
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Rough -in ...................
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0
Commercial Final
0
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HEATING:
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Gas Test ....................
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.
Gas Piping ...............
Equipment ...............
Commercial Final
EXTERIOR SHEATHING
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NAILING ..............
0
FRAMING ........................
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FIRST FLOOR FRAMING
Q 0
INSULATION ... ................
Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
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CIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ................