20020640.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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STATE LICENSE NUMBER
EXPIRATION DATE
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SIGN AREA
ALLOWED PROPOSED
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ALLOW 1B.I.SED
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LOT COVERAGE REOUIRED SETBACKS IFT)
PROPOSED SETBACKS (Fr.)
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CHANGE OF USE
ALLOWED PROPOSED
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REMARKS
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DESCRIBE WORK TO BE DONE
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Plan Check
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PLAN CHECK2L,
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Recording Fee
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SEPARATEPER
Engr. Review
City Surcharge
PER TTAPPLICATIC11:180 a
PRAMIT LIMM I YEAR - PROVIDE DAYS
Engr. Inspection
State Surcharge
SEC SACKOF PINK PER
—PLICA F OF H AgD B ... ESOPs
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Traffic Mitigation
Plan Chk Deposit
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IN INTEREST. AGREES T IN NIFN� THE CITY OF
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EDMONDS, WAIIIINGTOI FFICI , EMPLOYE , Alto AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DA ESO HAT ER NAT . ARE NO DIRECTLY OR INDIRECTLY
FROM THE ISSUAN, OF THIS IL ISSU OF OF THIS PERMIT SHALL NOT BE
DEEMEOTOMODII I Scale CE ANY QUIREMENT OF NY On ORDINANCE
Fire Inspection
Total Amount Due
NOR LIMIT IN ANY THE CITYS ILITY T NFORCE ANY ORDINANCE PROVISION!
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Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE RWHIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I Am THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This application is not a permit Vent signed ta, the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STAT OF WASHINGTON RELATING TO
FOR INSPECTION
Building Offl-i Im his/her napery; and Foes we paid, and
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WORKMENS COMPENSATION INSURANCE AND RCW 18.27.
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ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING STRUCTURE UNTIL
OR
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI�
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ...........
Wall ............. . ..........
Pier/Porch .................
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground .............
M
Rough -,In ...................
M
Commercial Final
C
HEATING:
m
GasTest ....................
IR
JD
Gas Piping .................
Equipment
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ................
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FIRST FLOOR FRAMING
INSULATION ...................
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Floor Insulation
Wall Insulation
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Coiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
171
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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OCCUPANCY ..............
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