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DATE 111111VID
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USEE PERMIT
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CITY OF EDMONDS IZ2�
CONSTRUCTION PERMIT APPLICATION JOB SUPTIAPTI
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REMARKS
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OCCUPANT
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DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD
$
Description
1i
FEE
Description
FEE
Plan Check
State Surcharge
BEAT SOURCE GLAZING % LOT SLOPE %
Building Permit
City Surcharge
PLAN CHECK NO: 111TED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. A14Y CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL. REQUIRE
Grading
SEPARATEPERIMISStON.
PERMITAPPILICATION: 100 DAYS
Engr. Review
PERMITILIM .11YEAFI-PREOVIDEDWORKISSTA EDWITHIN 180DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF I HIS OR HER 11111.111, HEIRS, ASSIGNS AND IUCCES1181
Fire Review
Plan Chit. Deposit
IN INTEREST, AGREES T INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
—
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOS DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCi OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE A Y REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Landscape Insp. I
Total Amt, Due
Recording Fee
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This,pplication [soot a permittooil,igned by We
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
111IftgOIficI.I.' 1,10h., D.p.y: sod Fs.... P.Id,toEd
FOR INSPECTION _sipli—k-wisclsolosp ... o.vId.d.
WORKMEN'Ydg-"SATI N INSURANCE AND RCW 18.27�
OFFIC]LS SIG DATE
1AT:;4L
(425)
�TUR
RELEASE By
ATTENTION
EXT 1333
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 COLD -ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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RECORD OF INS PECTIONS
INSPECTOR
DATE APPROVED
'bETBACKS
FOUNDATION:
Lo -a?
Footing ..............
wall
Pier/Porch
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
Gas let ............
Gas piping
Equipment
Commercial Final
EXTERIOR SHEATHING
NAILING .......... ; ...............
FRAMING ........................
FIRST FLOOR FRAMING;..
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
PAA9
MISCELLANEOUS ..........
FINAL APPROVAL FOR
(3
OCCUPANCY ..................
0110