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PERMIT PIRES Z 10Z
CITY OF EDMONDS
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.eLz�� (,-C461 I/ _j VALUATION $
Description FEE Description FEE
Plan Check
HEAT SOURCE I GLAZRIG I
LOT SLOPE
Building
PLAN CHECM
VESTED DATE
Plumbing
- 2,L
Mechanical
THIS PERMIT AUTHORIZED ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: B DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE "BIBLIC
2
Grading
Recording Fee
DOMAIN (CURDS. SIDEWALKS, DRIVEWAYS, MARQUESS, ETC.) WILL REQUIRE
SEPARATEPERMISSIGhL
EngL Review
City Surcharge
PERMITAPPLICATION: HKIDAYS
PERMIT UM I I YEAR PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engt. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS�ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND NO D HARMLESS THE CITY OF
EDMONDS WASHINGTON* He OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAJM� FOR DAMAGES OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDU E ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
Total Amount Due
0 NOR LIMIT IN ANY WAY THE CITY8 ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapainsp.
Receipt #
/ AM,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUG,
CALL
this application is not a permit until 81tined by Me
TION; AND IN ()DING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VtOLATI N OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
INSPECTION
�Ildlng Off
mca�clal or his her Deputy: and Fees are paid, and
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IFOR
WORKMENS COMPENSATION INSURANCE AND How 18.27�
1�1%Nl DATE
'SIG RE(OWNER AD
(425)
771-0220
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A'S OXTE
�nENTI�ON�T"
DIM 1333
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IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CRIMINAL - FILE - YELLOW, INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
IPAY
PINK - OWNER - GOLD - ASSESSOR
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SITg WRK GENERAL NOTES
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RECEIVED
SITE PLAN
MAY 17 2002
NOTES
BUILDING DEPT.
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing .............
wall ..................
Pier/Porch ............
Retaining Wall
Slab 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
3
OCCUPANCY ...............
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