20020764.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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NAME
USES PERMIT Ap 1-1
ZON NUMBER
76-5 SUITEIAPT#
ADDRESS
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PLAT NAMEISUBDIVISION NO. I LOT No, LID
LID FEE $
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REMARKS
OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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acaAr.NFq4ANqP1SrT1ON& PM UBC 1081FINAL INSPECTION REO'D
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Description
FEE
Description
FEE
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State Surcharge
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HEAT SOURCE GLAZING 14 LOT SLOPE IL
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Building Permit
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City Surcharge
PLAN CHECK NO:
P, ITT I
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE ORKNOTED, THIS PERMIT COVERS WORK 10
t 11 GONE I" PRI PROPERTY ONLY ANY 10"11111N (IN THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
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Engr. Review
PE MITAPPLICATKIN: 180DAYS
PERMIT UMTB 1 YEAR - PROVI ED WORK IS STARTED WITHIN 1 80 DAYS
See SACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt 0
ALL CLAIMS FOR DAMAGES OF WHAIEVER NATURE, ARISING DIRECTLY 08 INDIRECTLY
FIT M THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT E
0 EMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ADINANBE
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Total Amt. Due �719
N ORLIMrriNANYWAYTH CITYS ABILDYTO ENFORCE ANY ORDINANCE P`R__._".
Recording Fee
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I HEREBY ACKNOWLE BE THAT I HAVE READ THIS APPLICATION� THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER� OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMP WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
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TION; AND IN DING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR ODE OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTION roc,ird 1, ack—lodgad I..P.. P—ld.d.
WORKMEN'S COMPENS NSURANCE AND RCW IS 27.
OF 6 DATE
SIGNATURE J.WNER 0 BEAT) DATE SIGNED
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RELEAUD
ATfENTION
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-
ORIGINAL -FILE YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK - OWNEH GOLD -ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing, .............
Wall ..........................
Pier/Porch ...........
Retaining Wall ...........
Stab 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
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MISCELLANEOUS
FINAL APPROVAL FOR
10 10-0
OCCUPANCY ..................
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