20020933.pdfPERMIT EXPIRES
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CONSTRUCTION PERMIT APPLICATION
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OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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PROGRESS INSPECTIONS PER UBC 10S/1FINAL INSPECTION REOD
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Description
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Plan Check
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PLAN CHECK NO: VESTED DATE
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THIS PERMIT AUTHORIZES ONINTHE WORK NOTED. THIS PERMIT COVERS WORKTO
t: BE DOME ON PRIVATE PROPERTY ONLY, ANY CONSTRU ""0" ONTHEPUBLIC
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Grading
Recording Fee
no ES, UQ
MAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUE WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
City Surcharge
PE MITAPPUCATION: ISODAYS
PERMIT UMM I YEAR-PROVI 60 WORK 15 STARTED WITHIN 1 00 DAYS
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State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS,ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HO G HARMI - ,, ,,, OF
WASHINGTON, III OFFICIALS, MOM
Receipt #
EDMONDS, EMPLOYEES, AND AGENTS ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Review
FROM THE I SUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF My CITY ORDINANBEE
Fire Inspection
Total Amount Due
NOR LIMIT IN ANY WAY THE CrTYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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Receipt #
EREffy ACK14OWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFOAMAT ON
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
Saran is 0.1. pe-It.nill Signed by Me
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLAT F THE L BE OF THE STAT OF WASHINGTON RELATING TO
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ding Ofiic�al or Nalbar Oatcly: and FOOS are paid, and
FOR INSPECTION Haclipt Is llkamlodgod 1, space proAded.
WORHMEN!.O
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SIGZ;O�NEI! OR NED
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OFFICIALS SIG
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771-0220
FILLEAgEd BY IL-11 DATE
ATTENTION
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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-
ORIGINAL - FILE YELLOW "NSPECTO
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER GOLD - ASSESSOR
10101
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PT (07OXW—DING DIVISION
FROM: FIRE DEPARTMENT DATE__0
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE—
PROJEC
SITE ADDRES
PERAUT # ..... _-PATE INSPECTED—
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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:
25— yinal approval ofthe described work
_��IGRANT FINAL PROJECT APPROVAL
—GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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____yAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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SETBACKS .....................
FOUNDATION:
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FRAMING ... .....................
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INSULATION ...................
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Floor Insulation
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Wall Insulation ...........
Calling Insulation
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SHEETROCK NAILING