20020529.pdfPERMIT EXPIRES
CITY OF EDMONDS
USE
PERM T
NUMBER
CONSTRUCTION PERMIT APPLICATION
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PLAT NAMEISUBDIVISION NO.
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REMARKS
OWNERICONTRNCTOR RESPONSIBLE
FOR EROSION CONTROLIORAINAGE
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RENEWAL
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER
OF
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By
UN
rICAL
DESCRIBE WORK TO BE DONE
FIRE REVIEWED By DATE
VARIANCE OR CU
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PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
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THIS PERMIT AUTHORIZES ONLY THE WO KNOTED. THIS PERMIT COVERS WORKTO
I: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
0 Recording Fee
/7,
:I OUNN (CURES, SIDEWALKS, DRIVEWAYS. MARQUEES, airc.) WILL REQUIRE
SEPARATE PERMISSION,
Engr. Review
city surcharge
PER B'"p"ICATION: INDAYS
PERMIT LIMM. I YEAR - PROVIDED WORK IS STARTED WITHIN IN DAYS
Engr. inspection
State Surcharge
See BACK Of PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
In INTERESII� AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Receipt #
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS ED DAMAGES OF WHAT EVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Review
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT 8
TO =IFY, CITY ORDINANCE
Fire inspection
Total Arnount Due
DEEMED WAIVE OR REDUCE ANY REQUIREMENT OF ANY
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapalri
Receipt #
I HER58Y ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION; THAT THE
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
STATE CONSTRUC-
Thlar,pplicluse, " a.,, permit until signed by the
THE OWNER. I AGREE TO COME WITH CITY AND LAWS REGULATING
W
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
CALL
Be luting Official or Maine, Deputy: and Fee. are pritur.ad
QINFORMATION
LA
IN VIOLATIO OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
WORKMENS COMPENSATION INSURANCE AND RCW 18.27.
OFFI IG E DATE
SIGNATURE (OWNER OR
(425)
771-0220
ATTENTION
EXT 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELUOW,'INSP OR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER GOLD � ASSESSOR
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PER1vffr COORDINATOR, BUILDING DMSION
FROM: FIRE DEPARTNMNTDATE�_
t Lm� ERING DIVISION DATE
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PLANNING DIVISION DATE
PROJECT--LG-1=L—
SITEADDRESS
PERmrr # AO —()EM ADBk--DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED—FLnaj—
A field inspection was conducted to determine final compliance with approved plans. knal 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
a Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE-]NSpECtED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Si
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ..................
FOUNDATION:
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Pier/Porch .................
Retaining Wall
Slab Insulation
PLUMBING:
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Underground ...........
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HEATING:
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Equipment
Commercial Final
EXTERIOR SHEATHING
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FRAMING ........................
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FIRST FLOOR FRAMING —
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INSULATION ..................
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ...............
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