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PERMIT EXPIRES
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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PLAT NAME/SUBDIVISION NO.
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LID NO.
LID FEE $
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FRONT WASIDE HEAR
E3 ADDITION 13 COMMERCIAL El COMPLIANCE OR
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REPAIR [3 GRADING CYOS I _ X _ Fr)
REMARKS
DEMOLISH TANK 0 OT0,%_ Ala,,
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ISTEI DATE
Plumbing
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTEDL THIS PERMIT COVERS WORK TO
BE 00"' 1" PRIE PROPERTY ONLY. ANY COMM CTIONIONTHEPUBUC
DOMAIN JCURBS, SIDEWALKS, DRIVEWAYS'MARQUEES'ETC )WILLREQUIRE
Grading
Recording Fee
SEPARATE PERMISSION.
Engr. Review
City Surcharge
PERMIT APPLICATION: 180 DAYS
ERMIT LIND! I "A -PROVIDED WORK IS STARTED WITHIN ISOOAYS
EEBACKOFPIM RMIT FOR MORE INFORMATION
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Engr. inspection
State Surcharge
'APPLICAKI, ON BEHALF OF HIS OR "I" IPOUIE, "EIII, ASSIGNS IND SUCC.EORS
—11; "Ugation
Plan Chk Deposit
IN IWEFIEST� AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE C1"TY OF
Receipt #
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AN" AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER, NATURE ARISING DIRECTLY OR INDIRECTLY
Fire Review
FROM THE ISSUANCE OF THIS PERMIT. SSUAN& OF THIS PERMIT SHALL NOT BE
Fire Inspection
Total Amount Due
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DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CTIYS ABILITY TO ENFORCE ANY ORDINANCE PROVIStOrL'
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Receipt
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I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIOW THAT THE INFORMATION
IOVAL
GIVEN IS CORRECr, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNEIL I AGREE TO CO PLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
11 pi II, not. p—It fil Mp.d by th.
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TION; AND IN DOING THE WOFMIK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE "BOB CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
B.Itding ONO. /he,De ly:�d asarepokLand
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WORKMENS COMPENS USA D now 1 7.
OFFICIAL DATE
SIGNATURE IOWNIII 0
1111
(425)
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RELEASED By DATE
AT,TEATION
EXT 1333
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
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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FIRE DEPARTNIENT DATEA— 2-0 (7
FROM:
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PLANNING DIVISION DATE
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DESCRIPTION OF WORK TO BE INSPECTED
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A field inspection was conducted to determine compliance with -approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:tenip:b1dg:fbmis:ocaprv1 3/25/04
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ....................
FOUNDATION:
Footing ......................
wall
Pier/Porch .................
01
Retaining Wall
0
Stab Insulation
PLUMBING:
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Underground
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Rough -in ............ . .....
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Commercial Final
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HEATING:
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GasTest ....................
Gas Piping .................
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Equipment................
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Commercial Final
IT! IT
EXTERIOR SHEATHING
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NAILING ..........................
FRAMING ........................
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FIRST FLOOR FRAMING
INSULATION
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Floor Insulation
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Wall Insulation ...........
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Calling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................