20020814.pdfDATE RECEIVED
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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FLAT NAMSISUBDAdSION NO.
LOT 110,
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLA)RAINAGE
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Description
FEE
Description
FEE
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Plan Check
State Surcharge
HEAT SOURCE
LOT SLOPE %
Building Permit
City Surcharge
ITT
�STED DATE
Plumbing
PLAN CHECK NO:
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION N THE PUBLIC
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MIN (CURBS, SIDEWALKS, DRIVEWAYS, MAROU ES, ETC,) WILL REQUIRE
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SEPARATE PERMISSION,
PERMITAPPLICATION INDAYS
Engr. Review
PERMIT LIMIT I YEAR _ PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEC K OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
-APPLICANT, ON BEHALF OF His On HER SPOUSE, HEIRS ASSIGNS AND SUCCESORS
Fire Review
Plan Chit. Deposit
IN INTEREST AGREES TO RIDEM IFY, DEFEND AND H&S HARMLE S RTE CITY OF
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FICIALS, EMPIOYEES, AND AGENTS F .. ANY AN.
EDMONDS. WASHINGTON, ITS OF R
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY 08 INDIRECTLY
Fire Inspection
Receipt #
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT $HALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapoinsp.
Total Amt. Du
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NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
I HERE 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 CONSTRUC
CALL
This applu.11- 1, net a pounit 11 signed by Me
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Bull diag Offidal or has,inor Deputy: and Fees an, paid. 4
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WORKMFNS_�O�NSATION It SURANCE AND RCW 18.27.
(425)
OFFICIAL I E RATE
SIGNATURE�(OWNEJI( 08 AGE
771-0220
-,ELEASEDBY DATE
AttENTION
Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
ORIGINAL FILE 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/Porch .............. —
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in .............
Commercial Final
HEATING:
GasTest ....................
Gas Piping
Equipment .................
Commercial Final
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EXTERIOR SHEATHING
NAILING ..........................
FRAMING ..... . ...........
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
Wall Insulation ..........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
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