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VE STED DATE
Plumbing
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THIS PERMIT AUTHORIMS ONLY THE WORK NOTED, THIS PERMIT COVERS WORK To
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
t:
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION,
Engr, Review
PE ARTAPPLICAIN N: ISODAYS
PERMIT LIMIT. I YEAR 0 WORK IS STARTED WITHIN 180 DAYS
'PRO'No
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON EHALF F HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan ChIK Deposit
;APPUCANNT
N IWER ST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS. WASHINGTON. I'S OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt N
LY
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
ISSUANCE
ORDINANCE
Landscapoinsp.
Total Amt. Due
0 EMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY C TY
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE A. ORD1NANCE1j,N,..
Recording Fee
Receiptit
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN IS COB ECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
R W' U._
THE OWNER. I AGRE TO COMPLY WITH CITY AND 'TAYT RCGU ING CONSTRUC.
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CALL
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WORK I - M 11 N IN RANCE AND
0 DATE
SIGN OR AGENI T)
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RELEASED By DATE
EXT 1333
IT IS U WFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
W,
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-OWNEn G LD-ASSESSOR
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
I FROM: DEPARTNIENT DATE-
L_ ac-97- --- ENGINEERING DIVISION DATE -,7-7.102-
-PLANNING DIVISION DATE
PROJECT_�kn&an
SITE ADDRESS
02_
PERMIT # Oa-09 --ADB#--------PATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED.
A field inspection was conducted to determine final compliance with approved plans. Final approval
�denoteg that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of
V"'GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
I
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
SETBACK$ .................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall .......... 4
0
Stab Ins ulation
PLUMBING:
q 5i
Undetgtound .............
M
:C:
Rough -in .. .................
IT a .;��
0
Commercial Final
0
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HEATING:
x
M
Gas Tesf
Gas Piping-..
Equipment
0
Commercial Final
—4
ITI 1711
EXTFRIOR SHEATHING
a
NAILING ..........................
0
0 Fn
FRAMING j%-...*..",.�;
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PIRSfF%' 0 "' W
AM NO
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INSULAT09.
Floor Insulation
Wall Insulation ...........
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Coiling Insulation
ca
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SHEETROCK NAILING
SPECIAL INSPECTION
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ...........