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LPERMIT EXPIRES
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PERMIT
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METER SIZE I LINE Slii PAV REQUIRED
15 YES E3 No 13
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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1-711947
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE I EXEMPT ALLOWED �Slid ALLOWED BED
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EXP r* 19,61h 14'
NEW
ADDITION
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LOT COVER4GE REQUIRED SETBACKS (M. PROPOSED SETBACKS (FT)
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MULTIFAMILY
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NUMBER sea
OF UWMELLIN.
STORIES UNITS
DESCRIBE WORK TO BE DONE
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SPECIA L.I.NSPECTION JAREA OCCUPANT
REQUI 11 YES LOAD
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REMARKS
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
VALUATION
Description
FEE Description FEE
Plan Check
State Surcharge
HEAT SOURCE —I.. %
LOT SLOPE %
Building Permit
City Surgharge
PLAN CHECK
Plumbing
22
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
rharuca,
Mechanical
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t:
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
D as Grading
DWAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES. ETC.) WILL REQUI
SEPARATE PERMISSION.
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PIS MITAPPLICATION: INDAYS
Engr. Review
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 1.0 Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'A PLICANT.. N BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES T INDEMNIFY, DEFEND AND HOLD HARMLESS THE CHI OF
EDMONDS. WASHINGTON, ITS OFFICALSF CMPLOYEES, AND AGENTS FROM ANY AND
---
Fire Inspection
Receipt #
ALL CLAIMS,FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE SSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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DEEMED TO MODIFY. WAIVE 09 REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapeinsp.
Total Amt. Due 4,4—
Recording Fee
Receipt #
1:12 )j
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
GIVEN IS CORRECT AN. THAT I A. THE OMINEN On THE CULY AUTHOR 1E. AGENT OF
APPLICATION AWROVAL'
THE OWNER . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
DOING
CALL
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mituntl elped by Me
TION; AND IN TH WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
I VIOLATI
N ON OF THE
LABOR CODE OF THE STATE OF WASHINGT N RELATING TO
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WORKMEN'S CPM�IENSATION INSURANCE AND RCW U1.27,
FOR INSPECTION
In3P.e.P'A'jq.d.
I N TURE
SIGn WNERJOR AGEING DATE SIGNED
(425)
Pfic
10 �Ii !
771-0220
ATT9�
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EXT 1333
'JED BY
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
CATE OF OCCUPANCY HAS BEEN GRANTED. LED SECTION 109
OAX3WAL-FILE YELLOW -INS EdOH
04/02 PRESS HARD -YOU ARE
MAKING 5 COPIES
PINK -OWNER GOLD -ASSESSOR
GREEN,ACCOUNTING
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FINAL PROJECT APPROVAL FORM
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATIEL_
ENGINEERINGDIVISIONDATE—_
PLANNING DIVISIONDATE--L 9 �O
PROJECT
SITE ADDRESS,
PERM ADB#2Z--c9,-�-7aDATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTE
A field inspection was conducted to determine final coQliance with 1�p I approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
--2L-GRANT FINAL PR03ECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
Q 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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