20020718.pdfPERMIT EXPIRES
CITY OF EDMON6S
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NUMBER
CONSTRUCTION PERMIT APPLICATION
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PLAT NAMERIUDDIVISION NO
LID NO,
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ISTING PROPOSED—
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Description
FEE
Description
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Plan Check
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Building Permit
City Surcharge
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PLAN
VESTED DATE
Plumbing
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMITCOVERSWORKTO
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
a
Graciiing
:1 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
t: SEPARATE PERMISSION.
Engr. Review
PE MITAPPLICATION: JWDAYS
PERMIT ILIMM I YEAR - PROVID 0 WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
A911,6
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
1 CAM, ON BEHALF F HIS OR HER SIOURE. Eles. ASRl.NB AND SUCCESORS
INPIPULTIEFFEST, AGREES TO INDEMNIFY, DEFEND AND HOLD H AMLESS THE CITY OF
Fire Review
Plan Chk. Deposit
_F\
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt III
ALL CLAIMS FO DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT "
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY
La ndscapeinsp
Total Am 1. Due
ORDINANCE
NOR LIMIT IN ANY WAY THE CITYB ABILITY TO ENFORCE ANY ORDINANCE PROVISION.0
Recording Fee
Receipt #
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMAT'r
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OFF THE DULY AUTHORIZED AGENT F
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
Thi-ppil-I.. I. net. pe,reril until signed by fle.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELLATING TO
FOR INSPECTION
Building Olfiel.l., heene, D,pedy: and Fees are paid. z
..fpt is acknowledged 1, space pr,,Ided.
WORKMENS COMPENSATION INSURANCE AND RCW 18,27.
OFFICIALS SIGNATURE
SIGNA7yJW (OWNER
DATE Sl��)
(425)
7'71-0220
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ATTENTION
'�'�BUIUDING
EXI . 1333
RIIEASED BY Dxid
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IT IS UNLAWFUL TO USE OR 0 OR STRUCTURE UNTIL
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A FINAL INSPECTION HAS nr§c AND APPROVAL OR A CERTIFI-
�
ORIGINAL,FILE - YELLOW. INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
PINK -OWNER - GOLD�ASSESSOR
04/02 PRESS HARD -YOU ARE
MAKING 5 COPIES
GREEN - ACCOUNTING
IF
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ..........
Wall ..........................
Pier/Porch
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
M
Underground .............
M
0
0
Rough -In
C,
3:
Commercial Final
ITI
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HEATING:
C= :9
Gas Test ..................
Gas Piping .................
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0
Equipment
-n
.................
Commercial Final
M M
EXTERIOR SHEATHING
NAILING .......................
FRAMING ........................
M 0
FIRST FLOOR FRAMING
INSULATION ... ................
Floor Insulation
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Wall Insulation ...........
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Ceiling Insulation
2
SHEETROCK NAILING
0
IT!
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ...... ..........