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Description
FEE Description FEE
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Plan Check
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Building Permit
City Surcharge
PLAN CHECK NO: V11TEO DATE
Plumbfing
THIS PERMIT AUTHORIZES ONLY THE W RK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
t: 11 DONE ON P111 PROPERTY ONLK ANY CONSIAUCTION ON THE PUBLIC
DOMAIN
Grading
(CURBS, SIDEWALKS, DRIVEWAYS MAR LESS, ETC.) WILL REQUIRE
t: SEPARATE PERMiSSIONU
Engr. Review
PERMITAPPLICATI N; INDAYS
PERMIT UMI P. 1 YEAR -PROVIDED WORK IS STARTED WITHIN HODAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS a HER SPCIU�E. HEIRS, ASSIGNS AND SUCCESONS
Fire Review
PlanChk.Depoidt
I.L.BEIT. AGREES TO INDEMNIFY, DEFEND 111) HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON, ITS FFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
IS CL'J
ALL Me FOR DAMAGES OF OHATIEVER NATURE, AR SING DIRECTLY OR INDIRECTLY
Fire Inspection
Recelint #
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9 FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED To MODIFY WA VE DR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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Total Amt. Due
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
Receipt #
I HEREBY ACKNOW EDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND T14AT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
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THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
SfPROVAL
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TION; AND �-TLICIFFI�TE&T.Eflf�-6140 PER. . WILL BE EMPLOYED
IN VIOLATION OF THE , G STA , WASHINGTON RELATING TO
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FOR INSPECTION 0,121, gSdNn,p.c.pId.d.
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WORKMEN'S COMPEN ATION NS NICE AND Flow 18.27.
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SIGNATURE WN OX42fNV DATE E71E)
(425)
771-0220
ELIRASED BY D&E
A17ENTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIQNAt - Fit E YELLOW � INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
P.-OWNER GOLD -ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: P T 0", BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE-
_________gNGINEERING DIVISION DATE —
PLANNING DIVISION DATE—
PROJECT--4�U,—::��blj
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PERMIT # #________pATE INSPECTED �k
DESCRIPTION OF WORK TO BE INSPECTED--UITL9-6��
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of:
___,��e_Final approval of the described work AV
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ........... . ......
FOUNDATION:
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Retaining Wall
Stab Insulation
PLUMBING:
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Gas Test
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Gas Piping
Equipment .................
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EXTERIOR SHEATHING
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FRAMING .............
FIRST FLOOR FRAMING
INSULATION ...................
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Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................