20020845.pdf11111M DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
ER N�ME17,9.0,F BUSINESS
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HEAT SOURCE LOT SLOPE Plan Check State Surcharge
Building Permit City Surcharge
PLAN CHECK NO:
I VESTED DATE
Plumbing
THIS PERMITAUTHORIZESONLYTICE WORK .... THIS
PERMIT COVERS WORK TO
Mechanical
11 DONE I P111 1"OP11 ONLY, ANY CONSTRUCTION ON THE PUBIJ
DOMAIN SKIEWALKS,
Grading
(CURBS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRCE
it: SEPARATE PERMISSION.
Engr. Review
PERMITAPPLICIATI N: ISODAYS
A. PERMIT tusi I YEAR - PROVIDED WORK IS STARTED WITHIN 18a DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICANT. ON BEHALF OF HIS OR HER S"OUSE, HEIRS. ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND H to HARMLESS THE CITY 01
EDMONDS* WASHINGTON, ITS OFFICIAL% EMPLOYEES, AND AGENTS FROM ANY AND
Fire InsDection
Receipt It
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF MIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp.
Total Amt. Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
.
Recording Fee
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
By TH
GIVEN Is CORRECT; AND THAT I AM E OWNER. OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This application Is not a pencil until started by the
Tjoal� 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
WORKMENS COMPEN:=RANCE AND RCW 18,27,
FOR INSPECTION
Building Official., his/her Deputy: and Foos are paid,,
receipt 1, acknowledged happen pro,ided.
OFFICII S SI ATURE DATE
;�ENII
OATE SIGNED
(425)
�612 /1'
"�l /�R'011
771-0220
(RELEASED BY
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-
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
ORIGINAL - FILE YELLOW - INSPECTOR
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:
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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