20020729.pdfDATE RECEIVED
FPIERMITEXPIRES
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
'JOB SUITEIAPT#
ADDRESS
OWNER NAMEANAME OF BUSINESS
7 EM,
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PLAT NAMEISUBDIVISION NO.
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OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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FIRE REVIEWED BY DATE
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STATE LICENSE NUMBER TE VARIANCEOACU 1HORELINEORADIVO INSPECTION BOND
RE Q POSTED
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PROGRESS INSPECTIONS PER USIC 1081FINAL INSPECTION REG-0
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Description
FEE Description FEE
Plan Check
State Surcharge
JRCE
IPE
Building Permit
City Surcharge
PLAN CHECKJN01*
VESTED DATE
Plumbing
THIS PERMIT AUTHORIZES ONLY THE WORK NOTEM THIS PERMIT COVERS WO K
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WORK to
Mechanical
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BE DONE ON PRIVATE PROPERTY ON LXANYCONSTR CTIONONTHEPUBUIC
DO�N SIDEWALKS, U - U
Grading
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(CURBS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION, _' "FIE
2
15
PER;W.PPLJCA11.bK I. DAYS
PERMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection
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SEE BACK OF PINK PERA41T FOR MORE INFORMATION
sa 'A PLICANT, ON BEHALF OF HIS OR A SPOUS . HEIRS, ASSIGNS AND SUCCESORS
P HE E EB..G
Fire Fleviev,
Plan Chk. Deposit
IN INTERES17. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
E CITY OF
ED I SHINGTO ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS Y
Fire Inspect! n
Receipt #
FOR DAMAGEB OF WHATEVER NATURE, ARISING DIRECTLY OR INDIREC MY
FROM THE ISSUANCE OF THIS PERUR. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp.
Total Amt. Due
0 NOR LIMIT IN ANY WAY THE CLITS ABILITY TO ENFORCE ANY ORDINANCE PROVISION -
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Recording Fee
Receipt #
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I HEREBY ACKNOWLED E THAT I HAVE RE THIS APPLICATION; THAT
ACD THE INFORMATION
GIVEN IS CORRECT. AGO THAT AM THE WNER. Oil THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER, I ABBE TO COMPLY WITH CIT
T 0 D E Y AND STATE LAWS REGULAT114G CONSTRUC.
ION; AN IN OING
CALL
This appinfiflan Is not I Permit feell Signed by fee
THE WORK AUTO (ORIZED THEREBY, NO PERSON WILL BE EMPLOYED
N VIOLATION OF THE LABOR
Building Official of hislidu Deputy: and fees an, Paid, ane
CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND 11W 18.27.
FOR INSPECTION
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1 NATURE DATE
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771-0220
-A EV DATE
ATTENTION
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IT IS UNLAWFUL TO USE OR 06��DING OR STRUCTURE UNTIL
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC, SECTION 109
ORIGINAL -FILE YELLdN, INSPE6TOR
04/02
PINK -OWNER GOLD -ASSESSOR
PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN ACCOUNTING
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMOTO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
14�1_,���ENGINEERING DIVISION DATE
PLANNING DIVISION DATE�-
PROJECT
SITE ADDRE
PERMIT W,�
DATE INS C
11 DESCRIPTION OF WORK TO BE INSPECTED_-,
A field inspection was conducted to determine I lual compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
(3 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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nce—on OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall ...................
Plerlporch ...........
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in .............
Commercial Final
HEATING:
Gas Test .................
Gas Piping . .................
Equi pment
Commercial Final
EXTERIOR SHEATHING
NAILING ........... ..............
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...........
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
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