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aly OF EDMONDS
USE PERMIT
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CONSTRUCTION PERMIT APPLICATION
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INSPECTIONS PER USC 108/FiNAL INSPECTION REaO
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Recording Fee
ISORAWN (CURBS, SIDEWALKS, DRIVEWAYS MARQU ES, ETC.) WILL REQUIRE
SEPARATE PERM;SSION. '
Engr. Review
City Surcharge
PERMrrAPPUCAT1 H; INDAYS
PERIART LIM I YEAR - PROVIDED WORK IS STARTED WBIHIN 180 DAYS
.
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
State Surcharge
-IUCANT' ON BEHALF 011111 OR HER 'POU". HIMS. -SIGNS AND 11CC11ORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS 11011 ANY AND
Fire Review
Receipt # 4 f,
ALLCLAIMS PC DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INOIRECTLY
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FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT HE
1101 Ity"O"'WANEO RIIICEAIIEIUIIEII�OIAIYI,I.�D,NANCE
Fire Inspection
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IN 'M .A. WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
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Receipt #
AT
I HERESY ACKNOWLEDGE TH I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR TH DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER, I AGREE TO COMP I CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application Is— a re —I —el signed by IfIe
TION; AND IN 0011 WORK UT ZED THEREIN, NO PERSON WILL BE EMPLOYED
IN VIOLATION 0 T SAT 8 1 0 - CF HE STATE OF WASHINGTON RELATING TO
WORKMEN'S C P E gNo AM 18.27.
FOR INSPECTION
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SIGNATURE R GE
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OFFICIALS SIGNATURE DATE
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771-0220
DATE
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ATTENTION
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IT IS UNLAWFUL USTOR A BUILDING OR UNTIL
771-0221
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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FINAL PROJECT APPROVAL FORM
TO:
DATE: 11-1-n—o
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: --FIRE DEPARTMENT DAT
ENGINEERING DIVISION DATE-
0 PLANNING DIVISION DATEJ1=L2—=,:;�,
SITE ADDRES
PERMIT # Z—ADB#
_����DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED-12.�-�����
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
PERFORNL4,NCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
o Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
c3 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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INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
wait ............ 11 ............
Pier/Porch __ ..........
Retaining Wall ..........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final
HEATING:
GasTest ...................
Gas Piping ... ..............
Equipment . ................
Commercial Final
EXTERIOR SHEATHING
NAILING .................
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Coiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
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