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USEE PERMIT
CITY OF EDMONDS ZON NUMBEEXOJ_Ic�.
CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT#
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OWNER NAMEMAME
OF BuRINESS
4kPLAT NAMEISUDDIVISION NO. LOT NO. LID NO.
MAIIIN-AD RESS LID FEE III
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP T-P 4PI10
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PROGRESS INSPECTIONS PER UBC 1108/91FINAL INSPECTION REQ'D
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PLAN CHECK NO: VESTED DATE lumbing
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THIS PERMIT AUTHORIZES ONLYTHE WORK NOTED. 'THISPERMITCOVERSWORKTO Mechanical
I: HE DONE ON PRIVATE PROPEM ONLY. ANY CONSTRUCTION ON THE PUSUC
DOMAIN (CURBS,SIDEWA Grading Recording Fee
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LOS, DRIVEWAYS MARQU ES, ETC.) WILL REQUIRE
SEPARATE PERMission.
Engr. Review City Surcharge
PERMITAPPUCATION: IN DAYS
PERMIT LIMIT. I YEAR -PROVIDED WORK IS STAKED WITHIN ISODAYS Engr. Inspection State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON BEHAL OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND
AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS 0111CIAL6, EMPLOYEES, AND AGENTS FROM 1.1 Amo Fire Review Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATUP', A91SING DIRECTLY OR INDIRECTLY
FROM THE I SUANCE OF THIS PERMIT ISSUANCE F THIS PERMIT SHALL NOT BE Fire inspection untDua
TO MODIFY, Total Arno
TIT
DEEMED WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE -
NOR LIMIT 1. ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Landscapoinsp. Receipt
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION -
APPLICATION APPROVAL
GIVEN IS CORRECT AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
I E OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. CALL This application Is net a lannit-fil signed by Me
TION; AND IN DOING THE W UT .. IZE. THIETHERI,14. PER. . Wl- as EMPLOYS. 0.1171 off'olol,r hisma, Deploy: and Face- p.Id,.rId
VIOLATION OF THE %
IN C E OF THE STATE WASHINGTON FELATIN. I. FOR INSPECTION ocalps atialo-I.ag.d I.Itio.c. pnodd.d.
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WORKMEN 9; �;P"!SU CE AND
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RF(OWNER GENT E SIGNED (425)
771-0220 DAY'
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ATTENTION -1 f EX'T 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
10/01
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS
FOUNDATION:
Footlnd .............. :A
wall, ............. i
Pier/Porch ........... .
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Retaining Wall
Slab Insulation
PLUMBING:
Underground .............
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Rough -in .. .................
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Commercial Final
HEATING:
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Gas Test ....................
GasPiping .................
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Equipment ..............
Commercial Final
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EXTERIOR SHEATHING
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NAILING ......................
0
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FRAMING ......................
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FIRST FLOOR FRAMING
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INSULATION ...................
Floor Insulation
Wall Insulation
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Ceiling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................
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