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Description
FEE Description FEE
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Plan Check
State Surcharge
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LOT SLOPE %
Building Permit
City Surcharge
PLAN CHECK NO: VV TE. . Te
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY7HE ORK NOTED. THIS PERMIT COVERS WORKTO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN JCURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. FTC.l WILL REQUIRE
t: SEPARATEPERMISSION.
Engr. Review
PE MITAPPLICATION: 180DAYS
PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAIS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ART, ON BEHALF OF HIS OR HER SPOUSE, HE RS, ASSIGNS AND SUCCESONS,
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File Rendew
Plan Chk, Deposit
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It Rfr.FIES1 SEE. TO 11,1.11,11411 DEPEND AND LD HARMLESS THE Ciry OF
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2 EDMONDS, HINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
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Fire Inspection
Receipt #
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FLL CLAIMS FOR DAMAGES OF WHATEVER, NATURE. ARISING DIRECTLY OR INDIRECTLY
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'JAN'D
SOM THE CE OF THIS PERMIT, SSUANCE OF THIS PERMIT SNAIL NOT HE
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DEEMED TO MODIFY, WA VE OR REDUCE ANY REQUIREMENT OF ANY CITY ORINNANC -
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Total Amt. Due 1 45 —1 A
NOR LIMIT IN ANY WAY THE CITYS ILITY TO ENFORCE ANY ORDINANCE PAOVISJON�
Recording Fee
Receipt # La 2d
I HERESY ACKNOWLEDGE THAT � HAV READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS COFIRECT�, AND THAT AM THE OWNER, OR THE DULY A THOSIZED AGENT OF
A P I OVAL
THE OWNER. I AGREE To Cc PLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
TION; AND IN DOING THE WORK AUTHORIZED THESEITY NO PERSON WILL BE EMPLOYED
CALL
71, applititate Is not a peneltualil signed by the
Dural I Offle lorlys/ r Deputy: ard Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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WORKMEWS COMPENSATI=N E AND ACW 18,27,
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ATTENTION
EXT 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
OR GINAL - FILE YELLOW - INSPECTOR
PINK -OWNER GOLD -ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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EXP. 10/1
P.O. Box 31228 IFCI Ucense #
Seattle WA 98103 City Ucense # -6Z'2-
2WS47-8347
SITE PLAN
HEATING. OIL TANK DECOMMISSIONING
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Pump & dean one gallon underground heating oil tank. R11 with Structural
Polyurethane R)am. Cut off or remove vent and filler pipes and cap them
permanently below grade.
(Pump, Clean, and Cap)
Pump & Clean (Triple rinse) one-:W gallon underground heating oil tank. Cut
off or remove vent and filler pipes and cap them permanently below grade.
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Pump out one gallon underground heating oil tank. Excavate and remove
tank Men back fill hole and dispose of tank In the proper manner.
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FINAL PROJECT APMOVAL FORM
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MEMO TO: PERIM COORDINATOR, BUILDING DIVISION
FROM: --YIRE DEPARTMENT DATE
ENGINEERING DIVISION DATE—
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DESCRIPTION OF WORK TO BE INSPECTED
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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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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .................
FOUNDATION:
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Retaining Wall
Slab Insulation
PLUMBING:
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Equipment
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EXTERIOR SHEATHING
NAILING .................
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FRAMING ..................
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FIRST FLOOR FRAMING
INSULATION ...........
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Floor Insulation
Wall insulation . ..........
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Ceiling 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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