20020882.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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NAME
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ADDRESS 537 MAIN STREET
PI AT NAMEISUDDIViSION NO, Ll NO.
LID FEE $
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REQUIRED DEDICATION— PT
METER SIZE I LINE SIZE I NO, 01 FIXTURES PGV REQUIRED
YES 13 No 13
REMARKS
MN—CoNTRA-14 RESPONSIBLE FOR EROSION CONTROLJDRAINAGS
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THIS PERIMITAUTHORIZESONLYTHEW. KNOIED. T.11PIRMITCOVE01WORKTO
11 DONE IN GNLMANYCONST UMION ON THE PUBLIC
Grading
DOMAIN (CURDS. SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATEPERM;SSION.
Engr. Review
PERMITAPPLICATI N: INDAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN In DAYS
Engr, Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLIC W. ON BEHALF OF HIS 08 HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Fire Review
Plan Chk, Depos
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
S EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt It
ALL CLAIMS FOR DAMAGES OF WHATEVER, NATURE ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. SSUANCi OF THIS PERMIT SHALL NOT BE
CE
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DEEMED TO Mom", WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINA
NOR LIMIT IN ANY WAY THE C"S ABILITY TO ENFORCE ANY ORDINANCE PROVISINON.-
Recording Fee
Receipt #
I HERESY ACKNOW EDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
PPLICATION APPROVAL
GIVE IS CORRECT, AND THAT I AM THE OWNER, OR TH DULY AUTHORIZED AGENT OF
N E
I AGRE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
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Los 1, a Perm ims! ell end by me
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THE OWNER.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
VIOLAT ON OF THE USDA ODE OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTION is mini is moko I dg,d in spaces idmL
WORKMENSEN,SATION $$$$ SURANCE AND ACW 18.27,
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SIGN UR D
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(Q5)
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RE EA
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ATTENTION
EXr 133
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING STRU URE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED� UBC SECTION 109
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ORIGINAL, FILE - YELLOW � INSPECTOR
PINK-MNER - 00 -ASSESSOR
04102 PRESS HARD -YOU AR
KING 5 COPIES
GREEN ACCOUNTING
FINAL PliOJECT APPROVAL FORM
TO:
DATE:-.-Zg�/�
MEM 1 0 TO: pEpNUT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE —
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE-1� -16
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PROJECT
SITE ADDRESS
P DATE INSPECTED---LL'-'-
ERMIT
DESCRIPTION OF WORK TO BE INSPECTED
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A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL.
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
o Copy of CONDITIONS given to owner/contractor by inspector
I
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
ci 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 ..........
Stab Insulation
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PLUMBING:
Underground .............
Rough -in
Commercial Final
HEATIN G:
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Gas Test ...........
Gas Piping ...........
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Equipment .. ..............
Commercial Final
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EXTERIOR SHEATHING
NAILING ..........................
FRAMING .......... .............
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FIRST FLOOR FRAMING
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INSULATION ...................
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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