20020903.pdfDATE RECEIVZ,
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CITY OF EDMONDS
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PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB
SUITE/APT#
7WNFR —BUSINESS
ADDRESS 220P
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FLAT N�MVSUSOIVISIONI NO.
LOT NO. CID NO,
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ITY ZIP
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NAME
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NO� 01 FIXTURES YES REQUIRED
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ADDRESS
REMARKS
NERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
Illy ZIP ITELEPHON.
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CITY
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FIRE REVIEWED BY
DATE
STATE LICENSE NUMBER I EXPIRATION DATE BY
VARIANCE OR CU
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INSPECTI
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PL�MBING / MECH
LOT COVERAGE
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ADDITION
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GOOMPL`ANCE OR
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DESCRIBE WORK TO BE DONE
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REMARKS
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1
Plan FChock
77
Building
PLAN CHECK ESTED DATE
I
Plumbing
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
M I, I
Mechanical
BE DONE ON PRIVATE PROPERT)f ONLY. ANY CONSTRUCTION ON THE PUBIJ C
a 00 MAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,) WILL REQUIRE
Grading
SEPARATE PERMISSION.
PERMITAPPLICAMON 180DAYS
Engr. Review
PERMIT UMM I VEAR _ PROVIDED WORK IS STA OWITHMINDAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, 0 BEHALF F HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
IN INTEREST, REES INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
a EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
—
Fire Review
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE F THIS PERMIT SHALL NOT HE
DEEMED TO MODIF)� WAIVE OR REDUCE ANY
Fire Inspection
REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Landscape Insp.
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE CRY EIL OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUG'
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
CALL 8,
IN VIOLATION OF THE LABOR Cool OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
WORKMEN'S COMPENSATION)bISUIRANCE AND RCW 18.27.
SIGNATURE E" DATE SIGNED
(425)
I /0,�ZL'21
F
771-0220
ATYEkTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
10/01
FAX
)N Ic NT
0 cu
GROU
OCCUPANT
LOAD
UBC 1081FINAL INSPECTION REOD
FEE
Recording Fee
City Surcharge
State Surcharge
Plan Chk Deposit
Receipt #
Total Amount Due Zlo!�
Receipt # 1174) 7
"Ital., hIVInn U.Puly; and Feet are Paid. and
.Ipti,..k ... IaWn.p—p—Ided.
DATE
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IGNAL-FILE YELLOW. INSPECTOR
PINK -OWNER GOLD -ASSESSOR
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FINAL PROJECT APPROVAL FORM
TO
DATE:-2�ZW,9-51
7-7-
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATI�—
YNGINEERING DIVISION DATE —
PLANNING DIVISION DATE
PROJECT
SITE ADDRES .......... ........ . .
PERMIT #L��� &L—ADB# DATEINSPECTED-
NSPECTED
DESCRIPTION OF WORK TO BE I
A 'c
t'h �apprMvep a s. Final approval,
A field inspection was conducted to determine fina 'e. ompliance ei n
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
u Copy of CONDITIONS given to owner/contractor by inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
[3 Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date_ Sign_
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Fooling ......................
wall .. ............ ...........
z
Pier/Porch ............
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground
M
C
IT,
0
Rough -In ...................
-40
0 C
Commercial Final
HEATING:
3:
M
10
Gas Test ..............
Gas Piping .................
Equipment ............
Commercial Final
M M
EXTER OR SHEATHING
G
0
0
NAILIN ..........................
CA
FRAMING ...............
M C),
FIRST FLOOR FRAMING
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INSULATION ...................
Floor Insulation
z
Wall Insulation ...........
Ceiling Insulation
z
0
SHEETROCK NAILING
0
M
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................