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CONSTRUCTION PERMIT APPLICAT107N Jo
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REMARKS
OWNEFVCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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ALLOWED PROPOSED
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SETBACKS (FT)
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PROGRESS INSPECTIONS PER UBC 110S/IFINAL INSPECTION REO`O
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VALUATION
Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE
LOT SLOPE %
Building Permit
City Surcharge
PLAN CHECK NO:
RED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
It BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC
2
Grading
3 DOMAIN (CURBS, SIDIEWALyLS, DRIVEWAY$, MARQUEES, ETC.) WILL REQUIRE
t: SEPARATEPETIMISSION.
Engir. RWew
2-
PE RMITAPPUCATIOW INDAYS
Engr. Inspection
PERMIT LIMIM. I YEAR -PROVIDED WORK 15 STA TEDWITHIN 18.DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLI ANT ON BEHALF OF HIS OR HER SPOUSE , HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan ChIL Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY Of
2i EDMONDI WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLVMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE I SUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscape Insp.
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N OR LIMIT IN ANY WAY THE CITYS ABIL17Y TO ENFORCE ANY ORDINANCE PROVISION. -
ERecording
Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
AND THAT
APPLICATION APPROVAI
GIVEN IS CORRECT; I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUG,
CALL
Thl�.ppfi..I 11 b pft.nfiI.Igmd by th.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WOSKMEWS,��NSATION INSURANCE AND RCW 18.27.
FOR INSPECTION
ffuild,ng Offi-W., I,Wh., Dp.ly: d F — pdd.
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OR AGENT) DATE SIGNED
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771-0220
RELEASED BY 45ATE
A A ENTION
EXr 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
ORGINAL-FILE - YELLOW INSPECTOR
PINK -OWNER - GOLD -ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN _ ACCOUNTING
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: F DEPARTNIENT DATE --
ENGINEERING DIVISION DATP-q
PLANNING DIVISION DATIE�_
PROJECT
SITE ADDRESS 14 2t S_
PERNffr # 4,7 1 ADBk__DATE INSPECTED 11Y4 Z_
DESCRIPTION OF WORK TO BE INSPECTED
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
PERFO MANCE BONDS and the granting of:
GRANT FINAL PROJEC T APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 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_ Si
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACK$ ...........
FOUNDATION:
Footing......................
wall ..........
Pier/Porch .................
Retaining Wall
Stab Insulation
PLUMBING:
Underground ............
Rough -in ...................
Commercial Final
HEATING:
Gas Test ..............
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 ..................