20020595.pdfPIRES
PERMIT
CITY OF EDMONDS NUMIER &;0
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
ADDRESS
17 SWISS
07�
11
NAM
�U PLAT NAME;SUSDiVISION NO. LOT NO 110 NQ
LID FEE $
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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REMARKS
ADDRESS REMARKS
OWNFRICONTRACTOR RESPONSIULE FOR EROSION CONTRO LID NAGE
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CITY
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MUST BE PRESENT FOR
"NO'N"E"N. FIT) REMOVAL., OR UP
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ADDRESS
FIRE REVIEWED BY DATE
FIRE REVIEWED .
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VA131ANCE OR CU SHORELINEOHADSO INSPECTION BOND
I CHECKED BY JOYEs E3Nojs POSTED
STATE LICENSE NUMBER EXPIRATION DATE REGO
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Lo P OFO" LLOW' PROPOSED
EXEMPT ALLOWED PROPOSED ALLOWED
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PROPERTY TAX ACCOUNT PAR COMPLETE
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V3 RESIDENTIAL PLUMBING LOT COVERAGE REQUIRED SETBACKS (") PROPOSED SETRAC
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ADDITION COMMERCIAL CHANGSOFUSC
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PARKING LOT AREA PLANNING REVIEWED By DATE
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(TYPE OF USE, OUSINE OR A 11 CTfV EXPLAIN: CHECKED BY TYP�A�UCTION 0,,ROOPANT
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"NUMBER
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DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER uBC ./rI.AL I.SPIECTK). Ea.
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Description
D P
FEE
Description
FEE
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Plan Check
P IT C
State Surcharge
T S LOPE
HEAT SOURCE LOT SLOPE %
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Building Permit
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PLAN CHECK NO: DATE
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mechanical
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_-M_ OV E.- WORK To
THIS PERMIT ALIT ORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
IN F.
ON - ' - ".
BE DONE ON PRIVATE PROPERTY ONILX ANY CONSTRUCTION ON THE PUBLIC
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Grading
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WILL E..'.E
3 DOMAIN (CURBS,SIDEWALKS, DRIVEWAYS a I
PENM;MAI1 USES, ETC,), WILL REGO RE
SEPARATE SSION.
Er Review
PE MITAPPUCATION: INDAYS
NT-H` T.- SIAs
PERMIT LIMIT. I YEAR PFIOWD 0 WORK 15 STARTED WITHIN 180 DAYS
En IT. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-CES..
'APPLICANT, ON BEHAL OF His OR HER SPOUSE, HEIRSASSIGNS AND SUCCESCAS
..view
Fire Review
Fire
Plan Chk. Deposit
IN INT REST. AGREES TO INDEMNIFY, DEFEND AND He 11 HARMLESS THE rITY OF
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EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
spec"o
Fire Inspection
Receipt If
ALL CLAIMS ro DAMAGES OFWHATEVER NATURE, ARISING DISECILY OR INDIRECTLY
SHALL NOT BE
FROM THE ISSUANCE 01 THIS PERMIT. ISSUANCE OF THIS PERMIT
OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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Due
OEEMED TO MODIFY, WAIVE
NOR LIMIT IN ANY WAY THE CITYS ABILITYTOINFORCE ANY ORDINANCE PROVISION.-
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rE THAT T1,11.8. APPL'-T'.N; THAT THE INFORMATION
I HEREBY ACKNOWLEP HAVE
APPLICATION APPROVAL
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GIVEN IS CORRECT 'AND TUN A THE Duty AUTHORIZED AGENT OF
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Thl. ppIIi,.fi.. m P-11 bill �Igmd by
CITY AND STATE LAW EGULATIN
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THE OWNS . I TO COMPLY WIT
WILL BE EMPLOYED
CALL
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[ON: AND IN DOING THE WOF.,,IUTI �.'I�T�G T.E.TaVoN. PERSON
IN VIOLATION OF THE LABO oiu� . 's STA '. WASHINGTON RELATING TO
FOR INSPECTION IpIkn..I.dg.,Hp ... p$ftd.
'is
WORKMENS C,5�PPNSATION, NSUHANCE AND NOW 18,27,
0 l)ALSSI7A4Tn1
SIGNATURE WNF
(425)
,
771-0220
RELEASED BY
ATTENTION
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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 YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK OWNER 0 LO, ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —YIRE DEPARTMENT DATE —6 Z,
ENGINEERING DIVISION DATE
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PLANNING DIVISION DATE
PROJECT (gS tT-� 7—
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SITE ADDRESS 7
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PERMIT # D��a ADB# DATE INSPECTED 2
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DESCRIPTION OF WORK TO BE INSPECTED - —Lr-�'7
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A fleld 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
PERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
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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
SETBACKS . .....................
FOUNDATION:
Footing ......................
wall ....................
Pier/Porch .................
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Retaining Wall ...........
Slab Insulation
PLUMBING:
Underground .............
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Rough -In ...................
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Commercial Final
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HEATING:
hill
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Gas Test ....................
10-4
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Gas Piping .................
Equipment
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Final
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Commercial
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EXTERIOR SHEATHING
NAILING ..........................
0
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FRAMING ........ ...............
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FIRST FLOOR FRAMING
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INSULATION ...................
Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ............ .... .......... . 7-