20020571.pdfDATE RECEIVED
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CITY OF EDMONDS
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Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE GLAZING LOT Is
Building Permit
City urcharge 15-
PLAN CHECK NO:
lumbing
Mechanical
THIS PERMIT AUTHORIZED ONLY THE ORKNOTED. THIS PERMIT COVERS WORKTO
t: 11 DONE I PRIVATE PROPERTY 1141 ANY CIDISTRUIRIN ON THE P"11,12
Grading
DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PE MITAPPLICATION! 180DAYS
PERMIT UMM I YEAR. PROVID D WORK IS STARTED WITHIN 180DAYS
Engr. Inspection
SEC BACK OF PINK PERMIT FOR MORE 04FORMATION
*APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Fire Review
PlanChk.Deposft
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
STORES, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt III
FR M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
EEMED To MODIFY, WAIVE OR SEDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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0 NOR LIMIT IN ANY WAY THE CITYS ABILDY TO ENFORCE ANY ORDINANCE PROVISION.-
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AN T14AT I AM THE OWNER, OR THE DULY AUTHORIZE AGENT OF
T iE OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
, permit unit signed by the
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T:ON; AND AN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTION ipt Is acIdnovdodgld in op ... provided,
WORKMENS COMPENSATION
!Y�,U'RANCE AND RGW 1 .27.
YAJ E DATE
SIGNATURE (OWNER OF_AGf )ATE SIGNED
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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 YELLCIN-INSPECTO
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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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...........
FOUNDATION:
Footing ...........
Wall..........................
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Retaining Wall ...........
Stab Insulation ..........
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PLUMBING:
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Underground .............
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Commercial Final
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HEATING:
Gas Test ....................
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Gas Piping
Equipment ..........
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Commercial Final
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EXTERIOR SHEATHING
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NAILING _ ..................... -
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FRAMING .................
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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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