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PERMIT EXPIRES
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Building Permit
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PLAN CHECK NO:
ESTED DATE
Plumbing
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THIS PERMIT AUTHOFIIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS "S'ETC.) WILL REQUIRE
SEPARATEPERM;SMSIORNOU F
Engr. Review
PEIRMITAPPUCATI N: UIODAYS
PERMIT LIMIT. 1 YEAR- PROVIDED WORK is STARTED WITHIN IBODAYS
Engr. Inspection
SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION
'AIPLICAW' ON "HIALF OF HIS OR HER 11OU11, H1111. A11IrN1 AND 1U1C11O11
Fire Review
Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS ETON. ITS .11CIA11. EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt
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AILCL FOR DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT SSUANCE OF THIS PERMIT SHALL NOT BE
91 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUIREMEW Or ANY CITY ORDINANCE
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Total Am L [)us
0 MOB LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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Recording Fee
Receipt At
HERE. ACKNOWLEDGE THAT. E ... THM AIPLICATION: THAT HE I FORMATION
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IVI 111:0 FIE- AND THAT I AM -1 OWNER, OR THE DULY AUTHOR ZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
I N VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPETATp AND RC 10.27.
FOR INSPECTION
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ding Offiliel d, ISSIho, Deputy: and FOOS am paid, and
"C"pt ..dkn—tdd,md in.paad F-1d.tL
,j,W'SURANCE
SIGNATURE P-6, 0 AGE DATE SIGNED
(425)
OFFICIALS SIGNATURE DATE
4;�YA /() - -Z / -0 -.-->
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771 -0220
1,
DATE�
ATTENTION
1EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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"YEI�ilis;
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A FINAL IN PECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL- 11. - CTO
PINK OWNER - GOLD�ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
FINAL PROJECT APPROVAL F ORM
TO:
DATE:_M� �S
MiEmo To: PERmrr COORDINATOR, BUILDING DIVISION
FROM: ----FME DEPARTMENT DATE. -
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE�
PROJECT
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PERMlT#,6ftLZ2V 0
d-ADBk--DATE INSPECTED�
DESCRIPTION OF WORK TO BE INSPECTED
A field Inspection was conducted to determine f1mal compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFO BONDS and the granting of
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
t3 Copy of CONDMONS given to owner/contractor by inspector
I
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Si
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall... .......................
Pier/Porch ..........
Retaining Wall ...........
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Slab Insulation ..........
0
PLUMBING:
Underground ............
Rough -in ...........
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Commercial Final
M
0
0
HEATING:
-4
X M
Gas Test ....................
M
Gas Piping .................
Equipment .................
0
Commercial Final
EXTERIOR SHEATHING
M ITI
NAILING ................
FRAMING ............ ; ..........
C
FIRST FLOOR FRAMING
9
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INSULATION ................
Floor Insulation
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Wall Insulation ...........
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Ceiling Insulation
f SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................