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Description
FEE Description FEE
Plan Check
State Surcharge
LOT SLOPE
Building Permit
City Surcharge 15—
PLAN CHECK NO: TEO AT.
lumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE OnKNOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURDS, SIDEWALKS. DRIVEWAYS "AROUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. ReView
"BAMITAPPLICATION: 180 DAYS
PERMIT LIMIM I a. PROVIDEDW RK IS STARTED WITHIN 180DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICANT ON BEHALF OF HIS OR HER SPOUSE, 111111. A11IGN1 AND SUCCESORS
Fire Review
PlanChk.Depwh
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLE S THE CITY OF
M EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FO DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FA M THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED MODIFY, WAIVE OR REDUCE ANY REQUIREMENT CITY ORDINANCE
LandScapelnsp.
Total Amt. Due
TO OF ANY
0 NOR LIMIT IN ANY WAY THE GUYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Recording Fee
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
—
APPLICATION AP ROVAL
THE OWNER. I AGRE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC'
CALL
This application local 8 Ponalt debt signed by Me
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATI N OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Bultdloo Official o, Insrher D,pinly: old Fees are paid, and
lnncpfl...knwI.dg.d Jose ... p—lded.
WORKMENS COMPENSATION INSURANCE AND RCW 16,27,
FOATE SIGNED
1�=AGENO
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(425)
771-0220
-DELEAel.
.1 Un'E
ATTENTIONV
EXT 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL . FILE YELLOVY - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
PINK - OWNER GOLD - ASS SSOR
04102 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 ...........
Stab,insulation
PLUMBING:
Underground .............
Rough -In ..............
Commercial Final
HEATING:
GasTest ..................
Gas Piping ...........
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING .................
FRAMING ........................
FIRST'FLOOR FRAMING
INSULATION ........... . ..
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................