20020506.pdfT EXPIRES _2
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CITY OF EDMONDS ZONE PERMIT ?Z
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CONSTRUCTION PERMIT APPLICATION JOB so#
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REMARKS
OWNEFUCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDFUUNAGE
CITY ZIP ITILIPIRINE
NAME
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ENGINEERING REVIEWED BY DATE
ADDRESS
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STATE LICENSE NUMBER EXPIRATION DATE 11E1 BY
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DESCRIBE WORK TO BE DONE
REMARKS
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PROGRESS INSPECTIONS PER USC 110131FINAL INSPECTION REat),
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Description FEE Description FEE
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Plan Check State Surcharge
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HEAT SOURCE GLAZING % LOT SLOPE %
Building Permit City Surcharge
PLAN CHECK NO:
Plumbing
Mechanical
THIS PERMIT AUTHORIZIES ONLY THE ORKNOTED.THISPEINARCOVER WORKTO
I: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION Oil THE PUBLIC
M
Grading
:3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
t: SEPARATE PERMISSION.
Engr. Royiew,
PERMITAPPLICATION: INLAYS
F
PIERINUT Lt.. I I -AIR � P"o"D 0 WORK IS STARTED WITHIN IGODAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS ASSIGNS AND SUCCESORS
Fire Review Plan Chill. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
I.
EDMONDS, WASHINGTON ' ITS OFFICIALS, EMPLOYEES, AND AGENT S FROM ANY AND
Fire Inspection Receipt III
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
PROM THE ISSUANCE OF THIS PERMIT, ISSUANCi OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REGUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp. Total Arm, Due
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
---
Recording Fee �fo
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRIECt, AND THAT I AM THE OWNER� OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL Fhls application Is not a Palma until sJg,Kd by In.
IRONI; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
Building Official .1 plains, D.Puty: and Pass .1. Paid, ad
FOR INSPECTION nuccipt 1, ask—loagod loop ... lonAded.
WORKMEN'S COMPENSAT!gUINJURANCE No RCW 18.27.
OFFICIALS SIGNATURE DATE
DATE
at IGNED
(425) l� "
_LA —02
v� V _(
771-0220 RELEASED BY DKrE
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
:�A,3/62__
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELL06-INS4F.CTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK-MNER GOLD -ASSESSOR
04102 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 ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
L)
Gas Test ...........
Gas Piping . ................
CL(�
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING..........................
FRAMING ....................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
CellIng Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................
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