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PLAN CHECK NO: VESTED DATE
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THIS PERMIT AUTHORIZES ONLYTHE WORK NOTED, THIS PERMIT COVERS WORK TO
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PERMIT APPLICATION: IN DAYS
PERMIT LIMM I YEAR -PROVIDED WORK IS STARTED WITHIN INDAYS
K OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
'APPLICANT ON BEHALF OF "IS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Fire Revi"
Plan Chk. Deposit
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM AN AND
CLAIME1,101 D.A'MA111 OF VAIATEVIR y
Fire Inspection
Receipt #
IALL I NATURE. AF1014. DIRECTLY OR INDIR
FROM I. NBA �E or CTLY
THIS PERMIT. SSUANCE OF THIS PERMIT SHALL NOT B:
3 DEEMED TO MODIFY. WAIVE OR REDUCE ANY AEOUIREMENT OF ANY CITY ORGINANG
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Total Amt. Due
01 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Recording Fee
Receipt #
HEAESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GWEN IS CORRECT. AND THAT AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER, I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC,
TION; AND IN DOING THE
CALL
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WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR BE
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OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATI � SU INCE AND RCW 18.27.
FOR INSPECTION
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ENT) DATE SIGNED
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OFFICIALS PIGNATURE DATE
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771-0220
ENTIOW'
EXT 1333
RELEASE. BY I
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 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 YELLOW INSPECTOR
04102
PtNK-OWNER GOLD -ASSESSOR
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ....................
FOUNDATION:
Footing ............
f'wall ........... ..............
Pier/Porch ...............
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Retaining Wall ...........
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Slab Insulation ..........
PLUMBING:
Underground
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HEATING:
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Gas Test ....................
Gas Piping,
Equipment
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Commercial Fqnal
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EXTERIOR SHEATHING
NAILING ....................
0
FRAMING ........................
0
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0
FIRST FLOOR FRAMING
INSULATION ...................
;13
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
0
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ............
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