20020938.pdfDATE RECEIVED
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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on fuel -burning appliances in
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ADDITION
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Description
FEE
Description
FEE__
Plan Check
State Surcharge
GLAZING %
LOT SLOPE %
Building Permit_
City S�ILharg.
PLAN CHECK NO:
P In In.
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10-1
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Mechanical
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN
Grading
(CURBS, SIDEWALKS. DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
sEPANATrP1SRMiSSION.
R
PE MITAPPUCATION: INDAYS
Engr. Review
T PERMIT LIMIr. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
See BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLIC NT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFIIIIAII* EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT HE
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
91
Landscapeinsp.
Total And, Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
---UM-171—
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTI JORIZED AGENT OF
APPLICATION A—PgR—OVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
-
ALL
This appit-liett Is not, remit until signed by unt
IN DOING Th
TION; AND THEREUZ NO PERSON WILL
WORK AUTHORIZED BE EMPLOYED
OF
lul"I'll I "led -1 helhol Depoll: end Fluesten. pied,ined
IN VIOLATION THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S SPARti INSURANCE AND RCW 18.27,
��R INSPECTION
IIIIII I—Inenst.upd! lose ... reedd.d.
WNE 8 AGENFL DAT)7
(425)
dFAbALS SIGNATURE
0,2_
//7/
A7
771-0220
BE. a, ATY
WTTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNT1& EXT 1333
L,(,,, Lu� 22)
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
-7-
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
OR NAL - F4_-AELLOW INS ECTOR
04/02 PRESS HARD -YOU ARE
MAKING 5 COPIES
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NK-OWNER - GOLD-ASSESSOFT
GREEN ACCOUNTING
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Effective 7-12002
97 UMC
RECEIVED
NOV 14 2002
EFFECTIVE 7
PERMIT COUNTER
CITY COPY
FINAL PROJECT APLR_OVAL FORM
TO:
DATE:
MEMOTO: P CO NG DIVISION
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FROM: rP—L7*701'DIFIREDEPARTI�MNTDA:rE
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ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE —
PROJECT
srrEADDREss-
PERMIT 07 -q3-b ........ �ADB# ---- ��DATE INSPECTED—!�—(t �(6111
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there . are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
---4::�'61ZANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
13 Copy of COMMONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
c3 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:
Footing ......................
Wall..........................
Pier/Porch .................
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Retaining Wall ...........
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Slab insulation ..........
PLUMBING:
Underground .............
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Rough -in ................
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Commercial Final
M MT
HEATING:
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Gas Test ...........
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Gas Piping ................. MS
Equipm ant ................
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EXTERIOR SHEATHING
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NAILING
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FIRST�FLOOR FRAMING
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INSULATION
Floor Insulation
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Wall Insulation
Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
VA'S
11 -2777761
OCCUPANCY ..................