20020679.pdfCITY
NAME
AD11" I
DATE RECEIVED
'74D.2—
1 1
PERMIT EXPIRES
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
USE
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NUMBER
JOB
ADDRESS TE/AT'
ER NAMEINAME OF BUSINESS
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PLAT NAME/SUBDiVISION NO.
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LID NO.
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REMARKS
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NUMBER OF
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CRITICAL 111A_
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NUMBER
DESCRIBE WORK TO BE DONE
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FIRE RVIEWED By DATE
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REMARKS
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Description
FEE
Description
FEE
Plan Check
State Surcharge
LOT SLOPE %
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Building Permit
city Surcharge
_JVESTED DATE
PLAN CHECK N(Db�j
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK To
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
0 OMAIN (CURBS, SIDEWALKS, DRIVEWAYS MAR EES. ETC.) WILL REQUIRE
SEPARATE PERM;SSIONOU
Engr. Review
RE MIT APPLICATION: 180 DAYS
PERMIT LIMIT I YEAR - PROVID D WORK IS STARTED WITHIN IBD DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLIIANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST AGREES TO INDEMNIFY. DEPEND AND HOLD HARMLESS THE CITY OF
Fire Review
Plan Chk, Deposit
2 EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
IALL CLAIMS Fo DAMAGESOFWHATEVER NATURE, ARISING DIRECTLY OR;NDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
!3 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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01 NOR LIMIT IN ANY WAY TH CITT$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
R cording Fee
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Receipt III M
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
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
.."This ppilemian is not a permit until signed by Me
Met, Offilisl ., Nether D.pte,: d Fees .. P.Id, end
N ,
I IN VIOLATI S
'K ON OF THE LABOR CODE OF THE TATE OF WASHINGTON RELATING TO
LA7ENT1014-
FOR INSPECTION se. IF, I—In—InIged 1. IIp.s. p1m,lded,
WORKMENS NSA!!O INSURANCE AND RCW 18.27,
OFFI IALI II.NATU4,, DATE
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(425)
,�NATLI,�,G�WNE ,N--,IC
771 -0220
EXT 1333
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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 - �ELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER - GQLD�ASSESSOA
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ............
wall
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Pier/Porch ...........
Retaining Wall ...........
Slab Insulation
PLUMBING:
M
Underground .............
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0
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Rough -in ...................
Commercial Final
M
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HEATING;
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GasTest ..................
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Gas Piping
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Equipment
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Commercial Final-.'.*.'.'.'.'.
EXTERIOR SHEATHING
0
0 Fn
NAILING ...........
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FRAMING .....................
FIRST FLOOR FRAMING
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INSULATION ................
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Wal I Insulation
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Calling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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OCCUPANCY ...............
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