20020824.pdfDATE RECEIVED
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CITY OF EDMONDS N BIER d C
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT'
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ADDRESS
FLAT NAMSISUBDIVISION LID NO,
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ING ADDRESS Apee—
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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STATE LICENSE NUMBER
FIRE REVtEWED BY
DATE
BOND
POSTED
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ALLOWED PROPOSED
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PROGRESS INSPECTIONS PER URIC 1081FINAL INSPECTION REITO
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Description
FEE
Description
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FEE
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Plan Check
State Surcharge
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BEAT SOURCE LOT SLOPE %
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Building Permit
City Surcharge 166d
� AVESTEOLOATSELC
PLAN CHECK NO:
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE OAK NOTED. THIS PERMIT COVERS WORK TO
1: BE DONE IN 11111 PROPERTY ONLY ANY 11,111111" ON THE PUBLIC
Grading
I E
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIR
sEPARA-rEpEnmissiow.
Engr, Review
PERMnAPPUCATION: I.DAYS
PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF F 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
EDMOND5' WASHINGTON* ITS Offlclll�* EMPLOYEES, AND AGENTS 111111 ANY AND
Fire Inspection
Receipt #
All CLAIMS FOB DAMAGES OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM TH,,ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT HE
Landscapeinsp.
Total Amt. Due
DEEMED MODIFY, WAIVE 08 REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0. NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
�;
Recording Fee
I HEREBY ACKNOWLE GE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GWEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
This appi ufl,n is not a piernit-fil signed by Me
THE OWNER. AGRE 10 COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
E
TH WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
8,11 dieg Offi2l or hislien, De ety: and Fees an, paid, and
TION; AND IN DING
IN VIOLATION OF THE LABOR 0006 OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION receipt is acknowledged e, SpIll PrOvided,
WORKMEN3Z61r�llkSATION INSU NCE AND Row 1817,
'FFt DATE
81 DATESIGNED
(425)
WLS�
All A01/1 -7
ID
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771-0220
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ATTENTION
EXT 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
'NAL-FILE - YELLOW-DISPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER - GOLD-AqSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACK$ ...........
FOUNDATION:
Footing ..................
Wall .................
Pier/Porch .................
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0
Retaining Wall
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0
Stab Insulation
PLUMBING:
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Underground .............
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Rough -in ...................
0
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Commercial Final
HEATING:
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Gas Test .............
Gas Piping
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Equipment
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Commercial Final'..
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EXTERIOR SHEATHING
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NAILING . .........................
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FRAMING .. .............
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FIRST FLOOR FRAMING
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INSULATION ................
Floor Insulation
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Wall Insulation ..........
Ceiling Insulation
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SHEETROCK NAILING &N S
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SPECIAL INSPECTION
IT!
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................