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PERMIT E_XPIRES
... PERMIT
CITY OF EDMONDS Z-"E 1,2111�1,-;_ NUMBER4/,/'W
CONSTRUCTION PERMIT APPLICATION Joe SUITEIAPT�
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OWNER NAMEINAM F BUSINESS
PLAT NAMCISURDWISION NO LOT 7D NO OW- 7
MAILING ADDRES LID FEE S
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS%JIT COVERTSWORK TO
MECHANICAL
AN REU? 0WITHE PUBLIC
t BE DONE ON PRIVATE Pj=TY.O
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DOMAIN (CURBS� SIDEV WA LL REQUIRE
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SEMFATkP ON,
STATE SURCHARGE
PERMIT AP ATION: 18 A
PERMIT LIMIT, I YEAR PROVID WO SS TED IN 180 DAYS
ENTG� REVIEW FEES
SEE BACK 0, PINK P IT F7MOR FORMATION
HE
PLICANT. ON BEHALF OF HIS OR OUSE I!nSSIGNS AND SUCCESORS
ENG. INSPECTION FEE
IN INTEREST, AGREES TO INDEMNIFY, END F.LESS THE CITY OF
I EDMONDS, WASHINGTON, ITS OFPII L MIL I & AND AGENTS FROM ANY
ER RE AND
A LCLAIMS FOR DAMAGES OFWHAl TU ARISING DIRECTLY OR INDI CTLY
LANDSCAPIN
INSPECTION FEE
m FROM THE ISSUANCE OF THIS PET T I CE OF TRIP P IT SH NOT E
0 CITY G GOE
DEEMECTO MODIFY, WAIVE 08 REDUCE ANY REQUIREMENTOPAN � — , MNAN
PLAN CHECK DEPOSIT
RECE
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No IM INANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
TOTAL AMOUNT DUE
IF C�V/ ,/),7 1.7,
IHEREB ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFO
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE OULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
T E 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
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND ROW 18,27�
FOR INSPECTION 'Pt �dg� P,
SM53Z7TF (OWNER A E DATE
(425)
0 AT-- dNAT DATE
IGNED
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771-0220
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ATTENTION
EXT 1333
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IT ISUNLAWFULTOUSE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
FAX
ORIGINAL FILE - YELLOW/IN SPEAR
5198
PINK OWNER - GOLD -ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ...................
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wall ...................
Pier/Parch .................
Retaining Wall ...........
49
Slab insulation ..........
PLUMBING:
Underground
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Rough -in ...................
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Commercial Final
HEATING:
Gas Test ....................
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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FIRST FLOOR FRAMING
INSULATION ...................
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Floor Insulation
Wall Insulation
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Ceiling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
Ail"
OCCUPANCY .......................
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