20020587.pdfDATE RECEIVE PERMIT EXPIRES
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CITY OF EDMONDS NUMBER -053.)
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
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Description
FEE Description FEE
Plan Check
State Surcharge
HEAT SOURCE 0�lha I
LOT SLOPE %
STED DATE
Building Permit
Plumbing
City Surcharge
PLAN CHECK NO:
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
2 BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC Grading
D ONAIN
3 (CURBut, SIDEWALKS, DRIVEWAYS, MARQUESS, ETC,) WILL REQUIRE
t: SEPARATE PERMISSION,
2-
PERMITAPPLICATION: IN DAYS
Engr. Review
PERMIT LIMIT, I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire REVIEW
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
1DMOIID1* WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
A L CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE I SUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT HE
, AN TY IIDINA`N"
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY C
ORDINAN E
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NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION
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Total Amt. Due T 19�5
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Recording F Be
I HERESY ACKNOW EDGE THAT I HAVE READ THIS APPLICATION: HAT THE IN to
GRIM TON
GIVE" IS CORRECT; THE
APPLICATION APPROVAL
AND THAT I AM OWNER, OR THE DULY AUTIIORIZED AGENT OF
THE OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This appliCali- is net a p3anuft until signed by due
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
if cul or his/her Deputy: and Fees are Palo, and
0 OF THE LA 7;WE OF WAS
IN VIOLATI N All A HINGTON RELATING TO
WORKMENS COMPENS 18.27,
FOR INSPECTION
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SIGNATU R E GAT SIGNED
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OFFIC17LS DATE
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RELEASED BY' i_� I DATE
ENTION
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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.
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL � FILE YELLOW - INSPECTOR
04/02 PRESS HARD -YOU ARE
PINK -OWNER GOLD ASSESSOR
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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PERFORMANCE BONDS and the granting of:
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Sign—
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SETBACKS .....................
FOUNDATION:
Footing ......................
Wall . ..................
Pier/Porch .................
Retaining Wall ...........
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Slab Insulation
PLUMBING:
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Underground .............
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Rough -in ..........
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Commercial Final
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HEATING:
10-4
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Gas Test ....................
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Gas Piping .................
Equipment .., ..............
Commercial Final
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EXTERIOR SHEATHING
NAILING .................
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FRAMING .......................
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FIRST FLOOR FRAMING
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INSULATION ...................
Floor Insulation
Wall Insulation ...........
Calling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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