20020552.pdfDATE RECEIVED
PERMITEXPIRES
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PERMIT
CITY OF EDMONDS ZONE N U M 8 E R
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
ADDRESS
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PLAT NAMEISUBDJVISION NO LOT NO, LID NO.
MAILING ADDRESS LID FEE It
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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ADDITION rl COMMERCIAL C41ANGE OF USE
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PARKING I LOT AREA I PLANNING REVIEWED BY DATE
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REPAIR GRADING CYOS X FT) REMARKS
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DESCRIBE WORK TO BE DONE
REMARKS ION REOD
PROGRESS INSPECTIONS PER USC 108/FINAL INSPECT
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FEE Description FEE
Plan Check
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HEAT SOURCE LOT SLOPE %
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City Surcharge
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PLAN CHECK NO: STED DATE
Plumbing
Mechanical
THIS PERMIT AWHORIZES ONLY THE ORK NOTED. THIS PERMIT COVERS WORK TO
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTIR CTION ON THE PUBLIC
Grading
3 DOMAIN S, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
2 JOURIS
SEPARATE PERMISSION,
—
"'FIMITAPPLICAM Ph nadIDAYS
Engr. Review
PERMIT LIMIT. I YEAR IROVIO D WORK IS STARTED WITHIN I.BDAYS
Engr. Inspection
SEE BACK O�PINK PERMIT FOR MORE INFORMATION
:22'
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HFIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
Fire Revie.
Plan Chk. Deposit
ONDS WAS GTON, PT$ OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FO DA GES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt III
X FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Ist DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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Total Amt. Due
o NOR LIMIT IN ANY WAY THE CIWS AENU TY TO ENFORCE ANY ORDINANCE PROVISION.-
-
Recording Fee
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM I PIE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
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TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON REILATING TO
FOR INSPECTION
diets Chiller his/her Deputy: and Fecowepaid.and
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WON MEWS E SATIO INSURANCE AND RCW 18.27.
I DATE SIGNED
(425)
OFFICIALS SMIGIE DATE
771-0220
RELEASED BY DATE
ATTENTION
Off 1333
IT IS UNLAWFUL TO USE on OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
0810INAL-FILE - YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER - GO D�ASSESSOR
04/02 PRESS HARD -YOU ARE
MAKING 5 COPIES GREEN -ACCOUNTING
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A field inspection was conducted to determine final compliance with approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
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LERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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E3 Copy of CORRECTION NOTICE given to owner/contractor by inspector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date�._ Sign_
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ............
FOUNDATION:
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FINAL APPROVAL FOF
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OCCUPANCY .............