20020811.pdfI
DATE RECEIVED A PERMIT EXPIRES
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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STATE LICENSE NUMBER EXPIRATION DATE
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ADDITION CONINIEFICIAL COMPLIA 11 OR
CHANGE OF USE
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NUMBER
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NUMBER OF
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
1:
HE 0 NE ON PRIVATE IF OPERTY ONLY. ANY CONSTRUCT.ON ON THE PUBLIC
DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) "LL REOUIRE
SEPARATE PERM; SSION,
PERMIT APPLICATION: INDAYS
PERMITLIM I YEAR -PROVIDED WORK IS STARTED WITHIN ISODAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
FIT, ON BEHALF 01 HIS OR HER 1PO111, HIIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES. AN AGENTS PROM ANY AND
ALL CLAIMS FO DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FR M THE ISSUANCE F THIS PERMIT ISSUANCE OF THIS PERMIT SMALL NOT BE
0 EMED TO MODIFY. WAIVE OR RED CC ANY REOUIREMENT OF ANY CITY ORDINANCE
USIE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
I HEREBY ACKNOWLEDGE T iAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVE IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE 70 COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERS N WILL BE EMPLOYED
IN VIOLATI 4� 'I'D' Do' OF THE STATE OF WASHINGTON REILATING TO
WORKMAN' rCyTION 1'�URAN.E AN. CW U121.
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jDescription
FEE
Description
FEE
Plan Check
State Surcharge
uilding Permit
.u"d,ng Permit
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City Surcharge
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Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
Landscapeinsp.
Total Amt. Due
Recording Fee
Receipt #
'CAT "ON APPROVAL
CALL
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FOR INSPECTION
(425)
1 1
DATE
ATTENTION EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I I
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL�FIUE YELLOW. INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ..............
Wall .....................
Pier/Potch . ..........
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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