20020876.pdfAN DATE RECEIV
PERMIT EXPIRES
UIE
CITY OF EDMONDS ZONE
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OMER
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NAME
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTR ILIDRAINAGE
ITY
-NAME
ZIP TELEPHONE
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ENGINEERING REVIEWEDIDATE
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FIRE REVIEWED BY DATE
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STATE LICENSE NUMBER
EXPIRATION DATE
CHE KED BY
VARIANCE OR CU
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INS ECTION
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ALLOWED PROPOSED
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AILOW111 PROPOSED
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REQUIRED SETBACKS (Fr.)
FRONT SIDE BEAR
PROPOSED SETBACKS tFT)
FRONT URSIDE BEAR
AD DITION
0 COMMERCIAL
[3 COMPL CE OR
CHANGE OF USE
REMODEL
[3 APARTMENT
0 sirN
MINING REVIEWED By DATE
REPAIR GRADING CYOS 0 FENCE
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DEMOLISH [3TANK
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CGARAGE No WALL
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0 RENEWAL
RETAIN
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NUMBER
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NUMBER OF
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AREA
OCCU PANT
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UWEU_
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NUMBER
REQUIRED YES
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIO RU CIOWEWALWS��RIEG`D
lectors
reouired on To-' I.burningaPpliancesin
unheated Spaces-
Derscrintlon I �E_E
HEAT SOURCE GWING 11r LOT SLOPE 96
Building
PLAN CHECK NO: TED DATE
Plumbing
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THISPERUMAMHOR Of THE WORK NOTED. THIS PERMIT COVERS WORK TO
he S WO
Mechanical
t: 1111,1111 Is" PFICIIFERTY NLY. ANY CONSTRUCTION 0. THE PUBLIC
Grading
Recording Fee
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATEPERMISSION.
Engr. Review
City Surcharge
P P MITAPPLICATIGN: INDAYS
PERM1T UMM I YEAR - PROVIDED WORK IS STARTED WITHIN IN DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
M EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES Or WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE E
IS INUANC OF THIS PERMh. ISSUANCE OF THIS PERMIT SHALL NOT '
DEEMED To MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF YC"ORDINANCE
Fire inspection
Total Amount Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORD111ANCE PROVISION..
Landscapoinsp.
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED GENT OF
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
ThIslipplicaffioe Is no,. p.holt.ofillilgaN by Me
TION.' 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
Braiding Official or his"" o,puy: arld Fees she paid, a
WORKMENS COMPENSATI N�NIURANCE AND Flow 18.27.
ie
DATE
12
—1 1IGNEO
(425)
DAN
�;W;
771-0220
�lk
V
DATE
WffENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
ORIGINA -FILE - YELLOW INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
10/01
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .................
FOUNDATION..
Footing ... ...................
Wall ................ . ........
Plot/Porch ............
z
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground ..........
0 M
C
Flough-In ................
M
0
0
Commercial Final
M
HEATING:
M
10
Gas Test
Gas,PIping
...............
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING .......................
0
0
FRAMING ...............
C:
Z ca
mo�
FIRST FLOOR FRAMING,
INSULATION, .. ............
;D -
Floor Insulation
z
Insulation
Ceiling Insulation
z
SHEETROCK NAILING
SPECIAL INSPECTION
0
ITI
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ...............