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F"CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
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Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE GLAZING I
LOT SLOPE
Building Permit
City Sycharge
1_5
PLAN, CHECK NO: STE. ATE
Plumbing
IBMIT COVERS WORK TO
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Mechanical
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t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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Grading
OMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
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SEPARATE PERM; SSION. —
Engr. Review
PERMITAPPLICATION: INDAYS
PERMIT LIMIT I YEAR - PRORB ED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON BEHALF OF 1111 OR HER IFOU11, 111111, ASSIGNI AND �Lcc"..a
Fire Revie.
PlanChk.Deposft
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON* ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt #
FROM HE ISSUANCE OF THIS PERMIT. ISSUANCE F THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY WAIVE OR RED CE ANY REQUIREMENT OF ANY CITY ORDINANCE
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Total Amt. Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
Rocoling Fee
Racelpt 11
I HIRE ACKNOWLEDGE THAI 1 —1 READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM IT OWNER. OR THE OULY AUTHORIZED AGENT OF
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APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH On AND STATE LAWS REGULATING CONSTRUC-
CALL
This appi airier, 1. - a pan.!, snal signed by Or.
TIGN; AND IN DOING TH WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WAS14INGTON RE�TUVG TO
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dlng()Ific� at hieft, Depany: and Foes are paid. and
FOR INSPECTION reuipt 1, a,ka-hidg,d in space F—ided.
WORKMENS COMPENSATIO INSURANCE AND ROW 18,27.
0 IALS SI ATURE DATE
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AtTENtION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELLOW INSF`PtTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PNK.OWNER G LD.ASSESSOH
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
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DESCRIPTION OF WORK TO BE INSPECTED--=�i�����
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FINAL PROJECT APPROVAL FORM
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WMOTO: PERMTCOORDINATOPBLTILDINGDMSION
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ERING DIVISION DATE.—
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DESCRIPTION OF WORK TO BE INSPECTEP—
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
�,,----'GPANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDMONS NOTED
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
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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 ...........
Stab Insulation
PLUMBING: -
Underground
Rough -in ...................
Commercial Final
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ......................
FRAMING .......................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ........... ......
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