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PERMIT EXPIRES
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CITY OF EDMONDS
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REMARKS
INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
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Description
FEE
Description
FEE
Plan Check
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state Surcharge
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Building Permit 3167=
City Surcharge
PLANCHErp
Plumbing
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Mechanical
THIS PERMIT AUTHORPES ONLY iHE WORK NOTED. THIS PERMIT COVERS WORK TO
t 8 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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Grading
M DOMAIN (CURGES, SIDEWALKS. DRIVEWAYS IMAROU ES, ETC.) WILL REQUIRE
SEPARATE PERM;SSION. E
—
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P MITAPPUCATION: 180DAYS
Engr. Review
PERMIT LINIM. r YEAR - PROVID 0 WORK IS STARTED WITHIN HIDDAYS
Engr. Inspection
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit,
IN INT REST, AGREES TO INDEMNI", DEFEND AND HOLD HARMLESS THE CITY OF
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EDMON S, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt M
ALLC
FROM THE ISSUANCE OF THIS PERMIT SSUANCE OF THIS PSHMIT SHALL NOT E
BE
DEEMED TO MODIFY, WAIVE OR RED CE ANY REQUIREMENT OFANYCITY ORDINA.0
Landscapoinsp.
T G'.' m' Due
o IN OR LIMIT IN ANY WAY THE CHYa ABILITY To ENFORCE ANY ORDINANCE PROVISION,
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Recording Fee
—tReceipt
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I HEREBY ACKNOW"ED THAT IAVE READ THIS AIILICATI.N� THAT THE INFORMATION
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GIVE IS CORSE _.T. "AT �A. THE OWNER, OR THE OULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
IT" CITY T
0 S. [A MPLY W AND 8 ATE LAWS REGULATING CONSTRUC.
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Thi-ppacation, Is not a permit ami] signed by me
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1 1 RK AUTHORIZED ERE No PERSO
IN 00 1 N WIL, BE EMPLOYED
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IN R CODE OF THE STATE F WASHIN N RELATING TO
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FOR NSPECTION Inwipal-1, ... laia,rd 1, space P1111,11d,
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40 �N INSURANCE NOW 18tl'
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DATE
re"', DATE SIGNED
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771-0220
PATE
EXT 1333
IT IS= USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI�
ORIGINAL FILE YELLOW - INSIPECTIIW�
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK - OWNER G LD - ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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Cftr of (ftmodo
OF LOINGS
PER UNIFORM BUILDING CODE SECTION 109
At: 51 West Dayton Suite 301, Ed monds WA 98020
uilding Permit _2002-0993
Occupancy established by this certi ficate:
Dwelling Units: —NA-
No. Stories: 3
Basement: No
M aximum Load er;(J.B.C. 1002)
Roo a S, Mmust.rema* ate at 8# times.
Owner of Building: Edmon is Ba L o Dr.. OR 97035
THE EdLnonds 1jay Dental -HAS BEEN IN ANWAPP"ft X!"V REQUIREMENTS OF THE 1997 EDITION OF
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THE UNIFORM BUILDING CODE AS ADOPTED M-*;CITY'FOR. F OCCUPANCY AND THE USE FOR WHICH THE
PROPOSED OCCUPANCY IS CLASSIFIED.
Issued this 2003
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CHIE ILDING OFFICIAL
BY:—
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TNsm"��boomiedine�ow�pbucamand�gM�bemm�dmfll&tW���andshMlbemintainodintegib4omidUmatmt�. Anydmngeof��e�v�.4,4mabildingp.�t.W�n-
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMT COORDINATOR, BUILDING DIVISION
FROM: E
���FIRE DEPARTMENT DAT
ENGINEERING DIVISION DATE --
__------PLANNING DIVISION DATE -
PROJECT V`9 eLgo�L
Sr.rEADDRESS IAICA-r
PERMIT #aW2,��-.ADB#
INSPEC
DESCRIPTION OF WORK TO BE INSPECTED 7-
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
a Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
t3 Copy of CORRECTION NOTICE given to owner/contractor by inspector
I
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 ..........................
Pier/Porch .................
Retaining Wall ..........
Slab Insulation
PLUMBING:
Underground ............
rc) C;3
M
M 0
0
Rough -in ... ..........
I
0
Commercial Final
M ITI
HEATING:
C
Gas Test
Gas Piping ...............
0 Ti
Equipment .................
M M
Commercial Final
0
EXTERIOR SHEATHING
NAILING ............... ..........
0
0
M
FRAMING . ......................
0
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FIRST FLOOR FRAMING
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INSULATION ...................
Floor Insulation
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Wall Insulation ...........
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Ceiling Insulation
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SHEETROCK NAILING
M
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
4- Z
OCCUPANCY ............