20020512A.pdfDATE RECEIVED
FPERMIT
PIRES
CITY OF EDMONDS
ERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB ESS IUITEIAITI
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METER SIZE
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NO. OF FIXTURES
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REMARKS
WNERICONIPACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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PROGRESS INSPECTIONS PER ILISC 1108/FINAL INSPECTION REO'D
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VALUATION
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FEE
Description
FEE
ADedgeriptlon
Plan Check
StateSurcharge
HEAT SOURCE GLAZING % LOT St op. %
Building Permit
City Surcharge
PLAN CHECK NO-
L���
Plumbing
Mechanical
THIS PEFIMIT AUTHORIZES ONLYTHE WORK NOTED. THIS PERMIT COVERS WORK TO
tt HE DONE ON PRIVATE PROPERTY ONVt ANY CONSTRUCTION ON THE PUBLIC
Grading
0 ILL EQUIRE
ONUMN (CURBS, SIDEWALKS. DRIVEWAYS MARQUEES. ETC.) W R
Ic SEPARATEPERMISSION.
Engr. Review
PERMITAPPUCATI N: VMDAYS
PEAMITUM 11 Take -PROVIDED WORK IS STARTED WITHIN ISDOAVS
Engr. Inspection
. SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHAL OF HIS 01 HER 'POUSE. HEIRS,ASSIGNS AND SUCCESORS
I
Fire Review
Plan Chit. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND NO D HARM ESS THE CITY OF
EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATVE R, NATURE ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt N
FROM THE ISSUANCE OF THIS PERMIT. SSUANC� OF THIS PERMIT SHALL NOT HE
SEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF My CITY ORDINANCE
Landscapeinsp.
Tt.IAt.Du.
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
Receipt
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECP, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER, I AGREE TO CO PLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This sent cation 1, not a panne g signed by Me
TION; AND IN DOING WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
THE
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
8,11 ding Official or his/hal Olply: and Fels all Fels, and
FOR INSPECTION recolpt Is ackno,lodged I —pace pre,ided.
WORKMEN'S CO�MSATI INSURANCE AND RCW 18,27.
DATE
DATE "GIIED
(425)
& /;�Jo 7
771,0220
2L
RELEASED BY I /ATE
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-
ORGINAL-FILE - YELLOW- INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
PINK OWNER , GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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kNAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE —
_ENGINEERING DIVISION DATE—Ib�S 003
PLANNING DIVISION DATE—
PROJECT-- <9,eqL2:r—
SITEADDRESS-60� lie wo
PERMIT# Un-051" . ... .. ADB#_________-DATE INSPECTED--V�b
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection Was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE RONDS and the granting of:
--�—GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
o Copy of CONDITIONS given to owner/contractorby inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
E3 Copy of CORRECTION NOTICE given to owner/contractorby inspector
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Si
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DATE:—
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FROM: FIRE DEPARTMENT DATE—
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err ENGINEERING DIVISION DATE 03
PLANNING DIVISION DATE—
PROJECT— 0 T-
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PERMIT '0
0 1- ('2- ADB# —DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPEC
A field inspection was conducted to determine final compliance with approved plans. Final.approval,
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
-GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date_ sign_
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ............
FOUNDATION:
Footing .................
Wall,.... ..............
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Pier/Porch ............
Retaining Wall
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Slab Insulation ..........
PLUMBIN G;
Underground .............
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Rough -in . .................
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Commercial Final
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to
HEATING:
Gas Test
-4
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Ga. Piping ................
0 -n
Equipment ...............
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-4
Commercial Final
M IT!
. .......
0
EXTERIOR SHEATHING
0
NAILING ..................
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FRAMING
1311
FIRST FLOOR FRAMING...
INSULATION ............
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
0
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SPE61AL INSPECTION
MISCELLANEOUS .......... ---
FINAL APPROVAL FOR
OCCUPANCY ..................
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