20020909.pdfssIItIIIIs1 DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINACE
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STATE LICENSE NUMBER EXPIRATION DATE
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PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
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Description
FEE
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Plan Check
State Surcharge
HEAT SOURCE GLAZ.ING % LOT SLOPE %
Building Permit
City Surcharge
PLAN CHECK NO: VESTED DATE
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE ORKNOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
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2 1) ILL EQUI
t: SEPARATE PERMISSION.
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15 PE MITAPPLICATION: INDAYS
Engr. Review
PERMIT UMM I YEAR - PROW ED WORK IS STARTED WITHIN '60 DAYS
Engr. Inspection
SEE BACK Of PINK PERMIT FOR MORE INFORMATION
-APPLICANT, ON DEHJUF OF HIS OR HER SPOUSE, HEtRS,ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HO D HARMLESS THE CITY OF
.
EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FDA DAMAGES 0 WHATEVER NATURE, ARISING WRECrLY OR INDIRECTLY
Fire Inspection
Receipt #
FROM THE I SUANCE OF TH S PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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Total Amt. Due 7t5
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
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1 HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I Am THE OWNER. OR THE CURY AUTHORIZED AGENT OF
THE OWNER I AIRE TO COMPLY WITH CITY AND STATE LAWS REGULATING C.NSTRUC-
CALL
This application Is- a permit until signed by me
T.ft AN. IN DING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
N VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
Building Officialor his/her Dermly: and Feesmapaid, and
FOR INSPECTION "s"alpt I, ackdoeredged In spam, p—ided.
WORKMENrS COMPENS It SURANCE AND NOW 18,27,
RI DATE
SIGN� DATE SIGNito
(425)
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.jifATE
ATTE14TION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL FILE YELLOW- INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing .............
wall ..........
Pier/Porch .................
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in
Commercial Final
HEATING:
Gas Test ..........
Gas Piping: .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
t
Wall insulation
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR..
OCCUPANCY ............... .