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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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REGO I PROVIDED
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REMARKS
DDrIMPI IPJqPFCTIONS PER UBC 1081FINAL INSPECTION Fi
Description
FEE
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BiGe Surcharge
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Building Permit
CItY Surcharge
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ESTED DATE
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Mechanical
THIS PERMIT AUTHOR:%S ONLY VIE WORK NOTED. THIS PERMIT COVERS WORKTO
BE .. E ON MIN PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAUN (CURBS. SIDENVALKS, DRIV MARQUEES, i WILL REQUIRE
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PERMIT APPILICATIO : IN DAYS
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MIT ." Yl - PROVIDED WORK IS STARTED WITHIN 10 DAYS
PERMIT UMhr I Y P
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Engr. Inspection
SEE BACK OF PINK PERM" FOR MORE INFORMATION
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Fire Review
plan Chk. Deposit
ON BEHALF OF HIS OR HER SPOUSE. HEIRS�ASSIGNS AND SUCCESORS
HALF OF .
;APPLICANT.
I. INTEREST AGREES 70 INDEMNIFY DEFEND AND NO 0 HARMLESS THE CITY OF
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OFFICIALS. EMPLOYEES. AND AGENTS MOM ANY AND
Fire Inspection
RECEIPT It
ON ITS
EDMOND., WASHINGTON. ITS
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ALL CLAIMS FOR DAMAGES OF WHATEVER "TUBE, ARISING DIRECTLY OR INDIRECTLY
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL
0 CITY O.DIN" CB:
Landscalpel�sp
Total Annt Due
EEMED TO i WANE OR REDUCE ANY REQUIREMENT OF MY
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OR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDIN"ClE PRWISIOK
1 .0. LIMIT I . A Y 'N C'
Receipt III
I KERE"' ACKNOWLEDGE THAT I HAVE HEAD THIS APPLICATION; THAT THE INFORMATION
APP ICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
1i i `IW evd Oy i
THE OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
BE EMPLOYED
CALL
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VOW AND'N1 DOING THE WORK AUTHORIZED Th REBY, NO PERSON WILL
OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION 'i Is in sp jx�ded,
IN VIOLATI ON OF THE LABOR CODE
WORKMMS COMPENSATIO INSURANCE AND RON 18 27�
OF I I TE
SIGNATIURE (07 OR ATE SIGNED
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OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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FINAL PROJECT APP&OVAL FORM
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DATE:
MEMO TO: "*00 17 GDIVISION
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FROM: El, FIRE DEPARTM FNT DATE—f- i--/ 14 1 25
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE —
PROJECT
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DESCRIPTION OF WORK TO BE INSPECTED----L
n al compliance with approved plans. Mal approval
A field Inspection was conducted to determi e fin
denotes that there skre 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
c3 Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy ofCORRECnON NOTICE given to owner/contractorby inspector
2.
3.
RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date— Sigo—
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall ....................
PledPorch .................
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
GasTest ............ . ......
Gas Piping ..........
Equipment .................
Conunerelal Final
EXTERIOR SHEATHING
NAILING ..........................
:FRAMING ........................
-FIRST FLOOIR FRAMING...
INSULknow ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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CONSTRUCTION PERMIT APPLICATION
OWNER NAMEft"E OF BUSINESS
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PLAT NAMEISUBDIVISION NO. I
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�ROPERTY TAX ACCOUNT PARCEL NO. COMPLETE , EXEMPT ALL %Vs.
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LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSE13 SETBACKS (FT) 0
NEW 0 RESIDENTIAL [3 P MBINGIMS"N ALLOWED P�OPOEED FRONT SIDE REAR FRONT L11SIOE REAR
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ADDITION MERCLAL 0 CHANGEOFUSE
XCOM DATE M
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NUMBER REQUIRED 0 YES (j)
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REMARKS 'nON REGO
PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION REGO
4 41-6
VALUATION filud
Doscription FEE Description FEE z
Ran ChecX State Su,
GLAZING % LOT SLOPE %
Building Permit City Surcharge 5
PLAN CHECK NO, VESTED DATE Plumbing
Mechanical
THIS PERMIT AUTHOR121M ONLY THE WORK NOTEM THIS PERMIT COVERS WORK TO
I: SE DONE ON PRIVATE PROPIERTY CHLX ANY CONSTRUCTION ON THs PUBLIC Grading
ES, ETC.) WILL REQUIRE
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUE
SEPARATEPMURSSION. Engr. Revian
PER ITAPPLJOATION: ISOMYS ......
PERMIT UMM I
nm " PROVIDEDW RKIS"ARTEDW1TION INDAYS Engr. Inspection
am BACK OF PINK PEWIT MR MORE INFORMATION
-APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIM. ASSIGNS AND SUCCESORS Fire Review 150,— PlanChk.Deposit
IN INTEREST, AGREES To INDEMNIFI. DEFEND MO 110 HARMLESS THE CITY OF — Receipt III
Lo
EDMONDS, WASHINGTON, IT$ OFFICIALS, EMPLOYEES. AND I.$ ..- ANY AND Fire Inspection
ALL CLAIMS Es OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE 1=0 E
OF THIS PERM9. ISSUANCE OF THIS PERMIT SHALL NOT B Landscapoinsp. Total Amt. Due
EEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
N LIMIT IN ANY WAY THE CITYS ABILITY To N . Recording Fee Receipt N
OOR ENFORCE ANY ORDINANCE PROARSIO
IHEREBy ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPUi;AI ION APPROVAL
GWEN IS CORRECT, AND THAT I AM THE OWNER. OR TH DULY AUTHOFUZEo AGENT OF -.Wn 1, p—it unill slgn� tq
THE OWNE I AGREE TO COMPIN WITH CITY AND STATE LAWS REGULATING CONSTAUC_ CALL '."TN..ppIk , F�d.
ro RI THEREBY. NO PERS N WILL BE EMPLOYED dg OftW u �ftr D "d �as — F�d.
N; AND DOING THE WORK AUTHORIZED Ipt � �I4pwft:a�ce p�de&
0 F IOR INSPECTION
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKUMS COMPENSATION INSURANCE AND RCW H1.27. OF NATU
SIG NNCT 08t�� (425)
_THE (01 A4
0 R EASED BY
A 771-022 DATE
ATrtNTION EXT 1333 1
IT IS UNLAWFUL TiU�SE OR OCCUFY�A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR _11NMAL-FILE - YELLOW-1 SPE&OR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER -- 00 D-ASSESSOR
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
4 41-6
VALUATION filud
Doscription FEE Description FEE z
Ran ChecX State Su,
GLAZING % LOT SLOPE %
Building Permit City Surcharge 5
PLAN CHECK NO, VESTED DATE Plumbing
Mechanical
THIS PERMIT AUTHOR121M ONLY THE WORK NOTEM THIS PERMIT COVERS WORK TO
I: SE DONE ON PRIVATE PROPIERTY CHLX ANY CONSTRUCTION ON THs PUBLIC Grading
ES, ETC.) WILL REQUIRE
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUE
SEPARATEPMURSSION. Engr. Revian
PER ITAPPLJOATION: ISOMYS ......
PERMIT UMM I
nm " PROVIDEDW RKIS"ARTEDW1TION INDAYS Engr. Inspection
am BACK OF PINK PEWIT MR MORE INFORMATION
-APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIM. ASSIGNS AND SUCCESORS Fire Review 150,— PlanChk.Deposit
IN INTEREST, AGREES To INDEMNIFI. DEFEND MO 110 HARMLESS THE CITY OF — Receipt III
Lo
EDMONDS, WASHINGTON, IT$ OFFICIALS, EMPLOYEES. AND I.$ ..- ANY AND Fire Inspection
ALL CLAIMS Es OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE 1=0 E
OF THIS PERM9. ISSUANCE OF THIS PERMIT SHALL NOT B Landscapoinsp. Total Amt. Due
EEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
N LIMIT IN ANY WAY THE CITYS ABILITY To N . Recording Fee Receipt N
OOR ENFORCE ANY ORDINANCE PROARSIO
IHEREBy ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPUi;AI ION APPROVAL
GWEN IS CORRECT, AND THAT I AM THE OWNER. OR TH DULY AUTHOFUZEo AGENT OF -.Wn 1, p—it unill slgn� tq
THE OWNE I AGREE TO COMPIN WITH CITY AND STATE LAWS REGULATING CONSTAUC_ CALL '."TN..ppIk , F�d.
ro RI THEREBY. NO PERS N WILL BE EMPLOYED dg OftW u �ftr D "d �as — F�d.
N; AND DOING THE WORK AUTHORIZED Ipt � �I4pwft:a�ce p�de&
0 F IOR INSPECTION
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKUMS COMPENSATION INSURANCE AND RCW H1.27. OF NATU
SIG NNCT 08t�� (425)
_THE (01 A4
0 R EASED BY
A 771-022 DATE
ATrtNTION EXT 1333 1
IT IS UNLAWFUL TiU�SE OR OCCUFY�A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR _11NMAL-FILE - YELLOW-1 SPE&OR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER -- 00 D-ASSESSOR
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING