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PERMITEXPIRES
CITY OF
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PERMIT
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EDMONDS
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NUMBER 0
CONSTRUCTION PERMIT APPUCATION
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NAME
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110� .1 FIXTURES PRY REQUIRED
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ADDRESS
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDITAINAGE
CITY
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STATE LICENSE NUMBER EXPIRA CHIE[KED BY
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0 PLUMBING I MECH
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0 RETAINING WALL
CARPORT
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REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
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PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION
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THIS PERMIT AUTHORIZES ONLY THE ORKNOTED.1006 PERMIT COVERS WORKTO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
Grading
Recording Fee
2
3
DOMAIN ICURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
1:
SEPARATE PERMISSIOM
PERNIff"PUCATION: 160DAYS,
PARMETUMMIYEAR, 'PROV"' 0 WORK IS STARTED WITHIN IWDAVS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Cngr. Inspection
State Surcharge
'APPLICANT ON BEHALF 011111 OR HER SPOUSE, HEIRI, ASSIGNS AND IUCCEE.Ha
Traffic Mitigation
Plan Chk Deposit
IN INTEREST AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
Fire Review
Receipt III
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT HE
D EMED TO MODIFY, WAIVE OR RE UCE ANY AEOUIREMENT OF ANY City ORDINANCE
0
Fire Inspection A
Total Amount Due 15-
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0
NOR LIMIT IN ANY WAY THE DRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
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Receipt III
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CO RECT, AND THAT I AM THE OWNER, OR T14 DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
11— s P-11 1.11 liaa.d by 'be
CALL
Tjo N; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF TI �ODE 01 THE STATE 0 WASHINGTON RELATING TO
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FOR INSPECTION
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J��RKMEN's C.MPSN ars�N%AND RCVY 18.27.
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771-0220 -4-ELFASS
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7RtATION
EXT 1333
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IT
IS UN LAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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771-02
,
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
1,001GINAL - FILE YELLO . INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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VSrAEUMER* NO.9328111SO
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
DATE�
FROM: ---YIRE DEPARTMENT �1� �-—
GINEERING DIVISION DATE
PLANNING DIVISION DATE —
PROJECT
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PERMIT ADBk —DATE INSPECTED
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DESCRIPTION OF WORK TO BE IN SPECTED
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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
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PE RFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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a Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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o Copy of CORRECTION NOTICE given to owner/contractorby inspector
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3.
RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Si
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .............
FOUNDATION:
Footing _ ...................
Wall..........................
PierlPorch ...............
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Retaining Wall,
Slab Insulation ..........
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PLUMBING:
Underground .............
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Rough -in ...................
Commercial Final.
HEATING:
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Gas Test .............
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Gas Piping .................
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Equipment ..........
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Commercial Final
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EXTERIOR SHEATHING
NAILING ...................
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FRAMING .......... ...........
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FIRST FLOOR FRAMING....
INSULATION ..................
Floor Insulation
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Wall Insulation
Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................