20020723.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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REMARKS AINAGE
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUTIF
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DESCRIBE WORK TO BE DONE
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REMARKS
ROGRESS INSPECTIONS PER UBC 108INNAL INSPECTION REaD
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Description
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City Surcharge
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THIS PERMIT AUTHORIZES ONLY THE ViIORK NOTED. THIS PERMIT COVERIWORKTO
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t BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTR CTIONONTHEPUBLIC
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Grading
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3 OMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
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1: SEPARATE PERMISSION.
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PE MITAPPUCATION: IN DAYS
Eng, .W_
HIM I. DAYS
PERMIT LIMIT. I YEAR - PROVID 0 WORK IS STARTED WITHIN IN DAYS
Eng'. Inspection
Engr. Inspection
RON
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Fire Swim
FIT. Fwi.
PIanChk.DePOS
�Ns AN. SUCCE .. S
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS ANO SUCCESORS
R., E SS THE CITY OF
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AMD HOLD HARMLESS 1111 CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt III
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FR THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO Wool". WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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Total Amt. Due
NOR U IT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISIOfN.-
P:
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
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GIVEN IS CORRECT, A D THAT A THE OWNER, OR THE DULY AUTHORIZED AGENT OF
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THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
BE EMPLOYED
CALL
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TION; AND IN DOINGHTHE IN RK AUTHORIZED THEREBY. No PERSON WILL
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IN VIOLATION OF T LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTION
M"a Wd.d,
WORKMEN'S COMPENSATION INSURANCE AND ACIV 18,27.
SIGNATUR
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(OWNER OR KENT) DATE SIGNED
(425)
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1717 1 _11.1220 �PtVASE
DATE
ATTENTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ONIGINAL�FILE - YELLOW -INSPECT R
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK - OWNER GOLD�ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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FINAL PROJECT APPROVAL FORM
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Isamo To: PERmrr COORDINATOR, BUILDING DwisioN
FROM: FIRE DEPARTMENT DATE -
ENGINEERING DIVISION DATR-
PLANNING DivisioN DATE-IL�
PROJECT
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PERMIT # 6 V-3 ADB#LOZ-151 DATE INSPECTED
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DESCRIPTION OF WORK TO BE INSPECTED_1���-
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A field inspection was conducted to determine final compliance with, approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDMONS NOTED
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a Copy of CONDMONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
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RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign,
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7.
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing
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Wall......................
Pier/Porch ..........
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Retaining Wall ...........
Slab Insulation
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PLUMBING:
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Underground .............
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Rough -in
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Commercial Final
10
HEATING:
Gas Isl ....................
Gas Piping ............
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Equipment .................
Commercial Final
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EXTERIOR SHEATHING
NAILING ..................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
&7,L�
OCCUPANCY