20020794.pdfDAT
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OF GUIIIIISI
ING ADDRESS
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FEE
Description
FEE
PI an Check
State Surcharge
HEKr SOURCE GLAZING I LOT aLUPF %
uilding Permit
City Surcharge �5-
PLAN CHECK NO: VESTED DATE
Plumbing
mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPER11' ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, LTC.) WILL REQUIRE
SFPARATEPERM;SSION.
Engr. Review,
PERMITAPPLICATION: ISBOAYS
T
PERMIT LIMID I YEAR - PROVIDED WORK 13 START90 VA HIM 18B DAYS
SEEBACKO PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
*APPLICA ON BEHALF OF 111101 HER 11 E, HEIRS A SIGNS AND SUUCESORI
Nr OUS
Fire Rellew
Plan Chk. Deposit
CITY OF
IN INTEREST, AGREE$ TO INDEMNIFY, DEFEND AND HRDIRARMLESS THE CITY OF
N
EDMONDS . WASHINGTON. ITS OFFICIALS, EMP YEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
BE
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT
ORDINANCE
Landscapeinsp. ::=Total
Arnt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY
"OR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
Recording a
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; T14AT THE INFORMATION
By
PLICATION APPRO
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
11
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1P '"11101
THE OWNER. AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
'DING
CALL B. .1111.11P.111
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TION; AND IN 0 THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
E OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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IN VIOLATION OF THE
WORKIMENS COMPEN ION. U NCr AND RCW 1&27�
OF CI
I N E
--il—G—NATURE lOwNEIfOF1 AGENT) j DATE SIGNED
(425)
771 -0220 LEASED
BY
AT7'EWION
E)XffT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
OR G NAL � FILE YELLON � INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
P�NE�OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN - ACCOUNTING
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FINAL PROJECT APEROVAL FORM
TO:
DATE:
NIEMO TO: PERmrr COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTNIENT DATE_
ENGINEERING DIVISION DATE—t 0 6 J0?_
PLANNING DIVISION DATE —
PROJECT 0afit, r
SrM ADDRESS � vi 00 -71 la- Ave V\�
PERMIT 90_6��ft_ADBO —DATE INSPECTED 0
DESCRIPTION OF WORK TO BE INSPECTED-- V\/
A field inspection was conducted to determine final compliance With approved plans. Flual approval
denotes that there are no objections from the above signed Department to the release of
PERFQRMANCE BONDS and the granting of:
__)LGRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractorby inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date Sign_
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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
OCCUPANCY ..................
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