20020658.pdfPERMIT EXPIRES
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CITY OF MiVIONDS
CONSTRUCTION PERMIT APPLICATION
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STATE LICENSE NUMBER EXPIRATION DIE
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PROPERTY TAX ACCOUNT PARCEL NO. L7 06 1.3y 00000
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[Description
FEE
Description
FEE
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Plan Check
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State Surcharge
HEAT SOURCE GLAZING I LOT SLOPE I
Building Permit
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PLAN CHECK NO: 11STED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE W FIN NOTED. THIS PERMIT COVERSWORKTO
t HE DONE ON PRIVATE PROPEMPf ONLY. AW CONSTRUCTION ON THE PUBUC
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Grading
13
3 ONAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMiSSION.1
Engr. Review
PE MITAPPUCATION; INDAYS
PERMIT LIMIT. I YEAR - PROVID 0 WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BE -IF OF HIS OR HER SPOUSE, HEIII, AISIGN5 AND IUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
—
EDMONDS GTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS MOM ANY AND
Fire Inspection
Receipt #
CLAIM�WASHIN
ALL FOR DAMAGES OF WHATEVER, NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. SSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY WA VE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapeinsp.
Total Amt. Due 2,
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
Receipt # 61vr--)
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVE IS CORRECT; AND THAT I AM THE OWNER, 08 THE DULY AUTHORIZE AGENT OF
APPLICATION AP ROVA,
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
IN VIOLATION OF THE LADD OF THE STATE OF WASH INGTON RELATING TO
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FOR INSPECTION P ... P—iod,
WORKMENS COMPENSJ��E AND Now 18.27.
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771-0220
JILEASEDBY IATE
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
PiNK-OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING
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FINAL PROJECT APPROVAL FORM
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DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATIE�_
/W ENGINEERING DIVISION DATE—
��PLANNING DIVISION DATE__L_
PROJECT— -5—
SITE ADDRESS
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PERNffr #A100 -,�24 6-6' ADB#_A929�_/DATE INSPECTED�_
DESCRIPTION OF WORK TO BE INSPECTED. C2
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
BONDS and the granting of
GRAN, T FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL wrrH commoNs NOTED
o' Copy of CONDITIONS given to owner/contractor by inspector
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
1NSPECTOR DATE APPROVED
SETBACKS ............
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wail ...........
Slab Insulation ..........
Pl. UMBING:
Underground.............
Rough -in ..............
Commercial Final
HEATING:
GasTest ....................
Gas Piping .................
Equipment ................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ..................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation . .......
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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