20020965A.pdfDATE RECEIVED
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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ENGINEERING REVIEWED BY DATE
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
1: BE DONE ON PRIVATE PROPERTY ONLY, A" CONSTRUCTION ON THE PUBLIC
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Grading
DOMAIN (CURDS. SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
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Engr. Review
RE MITAPPLICATION: IN DAYS
PERMHrUMBEIYEAR-PROVI ED WORK IS STARTED WITHIN 80DAYS
Engr, Inspection
SEE SACK OF PINK PERMIT FOR MORE INFORMATION'
%PPLICAW. ON BEHALF OF HIS OR HER SPOUSE, HEMS, ASSIGNS AND SUCCESORS
IN INTEREST. AGREES To INDEMNIFY, DE11ND AND HOLD HAR111111 THE CITY 01
Fire Review Plan Chk, DePositj
IDMOND . WASHINGTON. ITS EMPLOYEES, AND AGENTS FROM ANY AND
& OHATEVER
Fire Inspection Receipt N
WFFICIALS,
ALL CLAIM FOR DAMAGES OF NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF 11111 111MI1. ISSUANCE F TIII1 PERMIT SHALL NOT BE
DEEMED TO MODI". WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp. Total Amt. Due
0 'OR LIMIT IN ANY WAY THE C S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Recording Fee Race ipt It
1 HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
OWEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
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R A IRE TO COMI IT" CITY AND STATE LAWS REGULATING CONSTRUC.
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This application ],,at a Parana unit signed by Me
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IKIV��.. A= IN RK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
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I : and Fees are paid, and
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FOR INSPECTION 'I d,adirlspe. —load.
IS PEN ATION INS CE AND RCW 18.27,
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(425) � A�SIGN
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771-0220 'JI-EA�ED BY
ATTENTION \
EXT 1333
I I I I " CU III "ING OR STRUCTURE UNTIL
AZA7 SPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELLOW -INSPECTOR
�ATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK-OWNEn GOLD�ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
FINAL PROJECT APEROVAL LORM
TO:
DATE:
MEMOTO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: ME DEPARTMENT DATE—
ENGINEERINGDIVISION DATE
PLANNING DIVISION DATE —
SITE ADDRESS
PERMIT #2—dQ., ADB# D
_____----PATEINSPECTE
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CTED
DESCRIPTION OF WORK TO BE INSPE
A rield inspection was conducted to determine rmal compliance with approved plaus�.i� Final approval
denotes that there are no objections from the above signed Department to the release of,
and the granting of
MANCE BQNDS
�-�GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITTI CONDITIONS NOTED
o Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
Q 1 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 ....................
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Pier/Porch
Retaining Wall ...........
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Slab Insulation ..........
PLUMBING:
Underground ............
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Rough -in ...................
0
Commercial Final
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HEATING:
Gas Test ....................
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Gas Piping .................
Equipment
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Commercial Final
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EXTERIOR SHEATHING
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N AILING ... .......................
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FRAMING ........................
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FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY