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THIS PERMIT AUTHORIZES ONLY THE We K NOTED. THIS
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Engr. Review
PERMIT UMm I Y PEJIMITAPPUCATI N4 INDAYS
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Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
1111C'11 ON BEHALF OF HIS 01 HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
Fire Review
Plan Chit. Deposit
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS
CLAJMBWAIHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
FOR DAMAGES
Fire Inspection
Receipt #
ALL OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL N OT
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DEEMED 10 MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINAN GRES
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NOR LIMA IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
Recording Fee
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I HEREBY ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION: T14AT THE INFORMATION
GIVEN IS CORRECT; AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
AND IN DOING THE
CALL
APPLICATION APPROVAL
This upplestaht, i,,,t a jasunit until Signed by Me
TJON� WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR
Suit nine Off�1181 or N3/har Deputy: and Fool 11, plid,,nd
CODE OF THE STATE OF WASHINGTON RELATING TO
WO"IMENS COMPENSATION INSURANCE AND NOW 1827�
FOR INSPECTION
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DATE
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ATTENTION
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RELEASED BY
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
ORIGINAL -FILE YELLCIN*INSPECTO
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PINK - OWNER Go 0 - ASSESSOR
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN, ACCOUNTING
fINAL ROJECT AVPROVAL FORM
TO:
DATE:
MEMO To: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE —
ENGINEERING DIVISIONDATE-11-1 I ot 10 2—
PLANNING DIVISION DATE_
PROJECT
SITE ADDRESS A-3 a t�d
PERMIT #jko-O-. �-Q 17 �0ADB#---------DATE 'NsPECT�ED—L�4A �Q—
DESCRIPTION OF WORK TO BE INSPECTED-5��' bo klut (rLp,
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:
—],�---GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy ofCORRECTION NOTICE given to owner/contractorby 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 ......................
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Pier/Porch .................
Retainihg Wall ...........
Stab Insulation ..........
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Rough -in ... .............
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Gas Piping .................
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Equipment ..............
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EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ........................
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Floor Insulation
Wall Insulation ...........
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Calling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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