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DATE, RECEIVED -7 [PERIMITEXPIRES
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REMARKS
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Description FEE Description FEE
Plan Check
State Surcharge
HEAT SOURCE GLAZING %
LOT SLOPE % Building Permit
City Surcharge
PLAN CHECK NO:
VESTED DATE Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTEM THIS PERMIT COVERS WORK TO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
OMAN (CURBS.SIDISMALKS.01TIVEWAYS MARQUEES, ET LL EQUIRE Grading
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SEPARATEPERMiSSION. Engr, Review
FERMITAPPLICATION: IN DAYS
A.
PERIMITLIM 1I YEAn -PROVIDED WORK IS STARTED WITHIN INDAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review
Plan ChIL Deposit
IN INTER ST, AGREES TO NDEMNIFY, DEFEND AND HOLD H RMLESS THE CITY OF
Receipt 0
EDMONDS, WASHINGTON OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FR M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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Total Amt. Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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ecording Fee
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
APPROVAL
GIVE IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY A THORIZED AGENT OF
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REOU ING CONSTRUC.
This application is a pannit inall signi'd by Sol
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
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CALL
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Building 011111al ol hisla"Maraty: and Pass .,a Paid, Ad
VIOLATION OF THE THE STATE OF WASHINGTON RELATING TO
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RELEASED BY
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL . FILE YELLOW � INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER GOILD-ASSESSOR
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MEMO TO: PERbIrr COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATE
ENGINEERING DIVISION DATI�__
PLANNING DIVISION DATE —
PROJECT' ZVLJ� Z
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SITE ADDRES
PERMIT '2002 — ADB#___----PATE INSPECTED_2_�&a7— �O.
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 BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WIT'll CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u 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 ...........
Pier/Porch ................
Retaining Wall ...........
Stab Insulation ..........
PLUMBING:
Underground
Rough -In ...................
Commercial Final
HEATING:
Gas Test ....................
Gas Piping
Equipment
Commercial Final . .......
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION _ ............
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..............
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