20020869.pdfi
RECEIVED —1 '[PERMIT EXPIRES f I I 1�_? �
CITY OF EDMONDS z
CONSTRUCTION PERMIT APPLICATION
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CITY JTILSPHONI
STATE LICENSE NUMIBER EXPIRATIO
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTEO� THIS PERMIT COVERS WORK TO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC�) WILL REQUIRE
SEPARATE PERMISSION.
P p ITAPPLICATION: 180DAYS
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PERMIT LIMIT�. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
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SEE SACK OF PINK PERMIT FOR MORE INFORMATION
�AP PUCANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
N NTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANYAND
ALLCLAIMS FOR DAMAGESOF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT HALL NOT
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TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY ON ORDINANC
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IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
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I HERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICAN ON. 1 HAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT 01
T E OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE L E OF THE STATE OF WASHINGTON RELATING TO
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REMARKS'
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RIANCE OR CU SHORELINE OR ADEUI INSPECTION I PSOI,D
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'ROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
VALUATION I FEE
PLAN CHECK FEE
BUILDING
PLUMBING
MEC14ANICAL
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ENE REVIEW I'VES
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ENG, INSPECTION FEE
LANDSCAPING
INSPECTION FEE
PLAN CHECK DEPOSIT
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RECEIPT
TOTAL A.OUNT DUE IRECEIPT
CALL
FOR INSPECTION
(425)
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APPLICATION APPROVAL
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RELEASED By ( -) /DATE t
A*htNT(ON EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221 ORIGINAL 'ILE YELLOW, INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ....................
FOUNDATION:
Footing ......................
wall ............
Pier/Porch
Retaining Wall ...........
Stab Insulation ..........
PLUMBING:
Underground
Rough -In
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commercial Final
-.10
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HEATING:
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Gas Test ....................
Gas Piping ..............
Equipment
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Commercial Final
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EXTERIOR SHEATHING
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NAILING ..........................
0 50
FRAMING . . .....................
0
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FIRST FLOOR FRAMING...
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INSULATION ...................
Floor insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................
CAPO
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