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CITY OF EDIVIONDT—T'
CONSTRUCTION PERMIT APPLICATION
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STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY
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U'NE 01 1 0_7 PERMIT (7
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PLAT NAMEISUBDIVISION NO.
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PUBLIC FIGHT OF WAY PEA OFFICIAL STREET MAP
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REMARKS
OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROUORAINAGE
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FIRE REVIEWED By
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LOT OVERIAGE RE UIRED SETBACKS (FT.) 0 SETBACKS (T
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—WE PROPOSED FRONT SIDE REAR FRONT
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9-DDITION COMMERCIAL o C MPLIANCE OR lot C.
13 CHANGE OF USE
VnPARKING LOT AREA I PLANNING REVIEWED BY DATE
EMODEL [3 APARTMENT rl SIGN REf PHOfED
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REPAIR GRADING CDS n F NOE
X Fn REMARKS
DEMOLISH 0 TANK 0 OTHER
oGARAGE ci RETAINING WALL 0 RENEWAL
CARPORT ROOKERY
UWE OF USE. BUSINESS OR ACTN" EXPLAIN:
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IN&Lf,- Eal`1416f CHE E OF CONSTRUCTION PA2,3
SPECIAL INSPECTOR JAR'
REOURIED [:] YES
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION REGO
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Description
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Description
Plan Check
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Building
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PLAN CHECr5� DATE
Plumbing
Mechanical
"IS PERMITAUTHORUIES ONLYTHEWOFIK NOTED. THISP611MIT COVER WORKTO
t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTR TIONONTHEPUBLIC
Grading
Recording Fee
OUMN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, E1Q.) WILL REQUIRE
SEPARATEPERMISSION.
Engr. Review
City Surcharge
PINIMITAPPUCATI N. INDAYS
PERMIT UUME I V, - PROVID D WORK 19 STARTED WITHIN 10 DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPUCANT. 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
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS 'I'D" ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE I SUANCE OF THIS PERMIT. ISSUANCE F THIS PERMIT S14ALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
Total Amount Due
J. 17'?,71"
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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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 AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC�
CALL
This appiaflon Is not a permit until signed
by am
TIOR 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
awmag Offil�.j , hislim, Deputy: and Fee,
FOR INSPECTION mc,lpt Is sel,emtodged in SpaCO
am paid, and
F—had.
RKMEN'S COMPENSATION INSURANCE AND RCW 18.27,
DATE
GAT
S17E (OWNER b GAT SIGNED
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offf�,IALS SIGNATu"
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771-0220
AVTCAjTInU
RELEASED BY
C%rr .112,212 x,
TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
IT IS UNLAWFUL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221 ORIGINAL -FILE YELLOW � INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER GOLD - ASSESSOR
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MLAL PROJECT APPAQVAL -F01kM
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A field Inspection was conducted to deterialue final co1ppliance withapprovedpigns. Final approval:
from the above signed Departatent to the release Of
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denotes that thwe an no objections
PERFORMANCE and the granting of..'
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GRANT FTNXL PROJECT APPROVAL
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GRANT PROjEcr APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
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FARM FINAL INSPECTION - OUTSTANDING ISSUES
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a Copy ofCOpjMCTlON NOTICE given to owner/conbactorby inspector.
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'INSPECTED OUTSTANDING ISSUES GRANT FINAL pRojEcr APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
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SETBACKS .....................
FOUNDATION:
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Footing ......................
wall
Pier/Porch .................
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Retaining Wall ...........
Slab insulation ..........
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PLUMBING:
Underground .............
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Rough -in ..................
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Commercial Final
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HEATING:
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Gas Test ....................
Gas Piping . . ..............
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Equipment .................
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Commercial Final
EXTERIOR SHEATHING yv-)
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NAILING ........................
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FRAMING ......................
FIRST FLOOR FRAMING...
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ANSULATION .................
Floor Insulation
Wall Insulation
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ................