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CONSTRUCTION PERMIT APPLICATION
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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REMARKS
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GARAGE
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DESCRIBE WORK TO BE BONI K
REMARKS
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Description
FEE Description FEE
Pj*�re CC;Lj
Plan Check
Slate Surcharge
HEAT SOURCE
G�INO I
LOT SLOPE
Building Permit
City Surcharge
PLA.CHECKNO:02 tICILI I VESTED DATE
Plumbing
C;_�
Mechanical
THIS PERMIT AUTHORIZES ONLY THE ORKNOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBUC
Grading
D OMAIN (CURDS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATEPERM;SSION.
2
Engr. Revim
PE MITAPPIUCAXION: INDAYS
PERMIT LIMIT, I YEAR - PROVID D WORK IS STARTED WITHIN I.DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AMD SUCCESORS
Fire Review
Plan Chit. Deposit
IN INTEREST. AGREES To IND MNII. DEFEND AND 11010 HARMLESS Till CITY 01
EDMOND"' WAIHINGTON. He .1110AIS, ENIPLOYs�., AND AGENTS I... A. AND
ALL CLAIMS FOR DAMAGES OF WHArEVER NATURE. ARISING DIRECTLY 08 INDIRECTLY
Fire Inspection
Receipt #
FROM THEiSSUANO 01 THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR RE ICE ANY REQUIREMENT OF ANY CITY ORDINA CE
Landscapelnsp.
Total Amt. D,
NOR LIMIT IN My WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
Receipt
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY UTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CI AND STATE LAWS REGULATING CONSTRUC.
CALL
This Fund "". Is a.,. runni—fil signed by he
7ION; 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
B.'IdInD Offic�re ov�hisftnn Deputy: and Fees are paid, and
hoillpt 11 alklo.lodged in space provided,
WORKMEN'S COMPENSATION INSURANCE AND DOW 16,27.
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to
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(425)
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771-0220
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ATTENY1614
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 - YELUCYN - INSPECTOR
PINK -OWNER - COLD ASS SSOR
04/02 PRESS HARD -YOU ARE
MAKING 5 COPIES GREEN - ACCOUNTING
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171
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...................
FOUNDATION:
Footing ......................
A
Wall ..........................
Pier/Porch
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
-dl
Underground .............
C
IT,
Rough -In ...................
0
0
C
Commercial Final
M
HEATING:
Gas Test .............
Gas Piping .................
Equipment .................
0
Commercial Final
Tin M
EXTERIOR SHEATHING
0
NAILING ..........................
0
FRAMING
........................
Q 0
FIRST FLOOR FRAMING
INSULATION .; .................
Floor Insulation
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Wall Insulation
Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
TR
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
COP