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PERMIT EXPIRES
CITY OF EDMONDS
USE ERMIT
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NUMBER 14
CONSTRUCTION PERMIT APPLICATION
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PROPOSED SETBACKS (FTJ
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VALUATION I FEE
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BEDONEON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADINGIFILL
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAY MARQUEES, FTC.) WILL REQUIRE
_T.
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SEPARATE PERMISSION.
VATU SURCHARGE
PE MIT APPLICATION; 180 DAYS
PERMIT LIMIT'. I YEAR, PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
MrON FEE
;APPLICANT. ON BEHAL OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
N NTEREST. AGREES TO INDEMNIF`Z DEFEND AND HOLD HARMLESS THE CITY OF
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LANDSCAF NO
, EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS 'ROM A�YAND
INSPECTION PEE
ALLCLAIMSFOR DAMAGESOF WHATEVER NATURE, ARISING DIRE LY OR INDIRED MY
FE-cEIPT
S RED
FROM THE ISSUANCE 11 HIS PERMIT. ISSUANCE OF THI RMIT SHALL NOT 5:
DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANC
ILAN CHECK DEPOSIT
0 OF PROVISION.'
NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANY ORD ANCE'RoV"B '
cEIPT2(
TOTAL AMOUNT DUE
IR
I HERESY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION. THAT THE INFORMAI ION
APPI IdATION APPROVAL
GIVEN S CORRECT, AND THAT AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH Cl IY AND STATE LAWS REGUILA7ING CONSTRUG
CALL
Th's pplji �, 1 , pq by th,
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE F THE STATE OF WASHING10N RELATING TO
FOR INSPECTION
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WORKMENS Coy R�'j A E AND RCW 18.27,
OF OUL N�T E
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771-0220
DATA
ATTENTION
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IT IS UNLAWFULTO USEOR OCCUPYABUILDING OR STRUCTURE UNTIL
, .
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
oRIGI'MAL .-FILE YELLOW . INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER GOLD - ASSESSOR
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FINAIEROJECT APPROVAL ^,M
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MEMO TO: P �ATBUILDING DIVISION
FROM: —rIREDEPART1�ffiNTDAT,7
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE
PROJEC
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PERMIT # -q
ADB#-----------DATE INSPECTED.
DESCRIPTION OF WORK TO BE INSPECTED...
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of:
____��Final approval of the described work
Bonds associated with the project may be released
GRANT FINAL PROJECT APPROVAL
_GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
____FAILED FINAL INSPECTION - OUTSTANDING ISSUES
1.
2.
3.
-INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ...........
FOUNDATION:
Footing ................
wall...................
Pier/Porch
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough4n ................ .
Commercial Final
HEATING:
Gas Test ..............
Gas Piping ..........
Equipment
Commercial Final
EXTERIOR SHEATHING
NAILING .............
FRAMING ........................
FIRST FLOOR FRAMING..
INSULATION
Floor Insulation
Wall Insulation
Ceiling Insulation
SHEFTROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..............
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