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PERMIT EXPIRE
CITY OF EDMONDS
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PERMIT
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NUMBER 6
CONSTRUCTION PERMIT APPLICATION
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ADDRESS
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP ITELEPHONE
NAME C_d;ni(-Cr =:-nJUf+fLlHan ICBLIW
SNGINEE.1N. REVIEWED
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FIRE REVIEWED BY
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VALUATION
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Description
FEE Description FEE
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Plan Check
State Surcharge
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BEAT SOURCE LOT SLOPE %
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Building Permit
City Surcharge
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PLAN CHECK NO� VESTED DATE
Plumbing
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Mechanical
THIS PERMIT AUTHORIZIB� ONLY THE ORK NOTED. THIS PERMIT COVERS WORK TO
0 DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ONTHE PUBLIC
DOMAIN (CURSS, SIDEWALKS, DRIVEWAYS, MARQUEES,
CA, kiz
ETC.) WILL REQUIRE
SE.EPa..ISSION.
Engr. ReView
PE MITAPPLICATION: INDAYS
PERMIT LIMIT. I YEAR -PROVIDED WORK IS STARTED WITHIN ISODAYS
Engr, Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLI ANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Fire Review
—
Plan Chk, Deposit
kd
E MOND$, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMA ES OF WHATEVER NATURE, ARISING DIRECTLY 09 INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMEDITTO MODIFYAYWAIVE OR REDUCE ANY REQUIREMENT OF ANY C TY ORDINANCE
Landscapelrap.
Total Amt. Due
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01 NOR IM IN ANY �j THE CITY�S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Recording Fee
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION A :2
THE OWNER. I ACRE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
CALL
--I-
TION: AND IN DOING THE WORK AUTHORIZED T EREBY NO PERSON WILL BE EMPLOYED
THE STATE OF WASHINGTON .�LATI*.
IN VIOLATION OF THEALA
F. nd
NO�l To
T);rWORKMEN'S COMPENS NT_ AND RCW 10,21,
FOR INSPECTION
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I DATE SIGNED
SIGEE (RWNE:�
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ATTENTION
EXT 1333
YLEP�SED BY DATE'
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. UBC SECTION 109
PINK -OWNER GOUD-ASSESSOA
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING
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FINAL PROJECT APPROVAL FORM
TO
DATE:
NMMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPAR11VMNT DATE
ENGINEERING DIVISION DATE— z
PLANNING DIVISION DATE--!/—/ --6E
PROJECT LAA�6 -4
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DESCRIPTION OF WORK TO BE INSPECTED-CA-�����
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A field Inspection was conducted to determine final compliance with approved plans. Fina
denotes that there are no objections from the above signed Department to the release of 0 -n
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GRANT FINAL PROJECT APPROVAL C CO
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED z
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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2.
3.
RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date_ Si
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INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ....................
wall ..........
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Pier/Porch
Retaining Wall ...........
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Slab Insulation ..........
PLUMBING:
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Underground .............
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Commercial Final
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HEATING:
ID —4
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
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INSULATION .
Floor Insulation
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Wall Insulation
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Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................