20026024.pdf1�1 DATE RECEIVED
PERMIT EXPIRES .'4
PERMIT
CITY OF EDMONDS NUMBER 6,2-
CONSTRUCTION PERMIT APPLICATION JOB
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REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTEM THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURB S, SIDEWALKS, DRIVEWAYS. MAAQUEES� ETC.) WILL REQUIRE
GRADINGIFILL
SEPARATE PERMISSION.
�TATElURGHAFGE
PE MIT APPLICATION: 180 DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG, REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPL(CAN-L ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
ENO INSPFCTION FEE
IN INTEREST. AGREES TO:NDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS WA HINGTON TS OFFICIALS. EMPLOYEES. AND AGENTS FR ANYAND
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ALL CLAIMS FOR DAMAGESOF WHATEVER NATURE, ARISING DIRECTLY OR tNo RECTLY
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THIS PERMITL ISSUANCE OF THIS PERMIT SHALL NOT L
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I HEREBY ACKNOWLEDGE THATI HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN IS CORRECT, AND THAT I A14 THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONST RUG
CALL
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RON AND IN DING THE WORK AUT11OR12ED THEREBY, NO PERSON WILL BE EMPI.OYED
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IN VIOLATION OF THE LA STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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WORKMEN'S CONIPENSA I RCW 18.27
OFFICIALS SIGNATURE DATE
D ATI � 11
(425)
Z�7�EEL
771-0220
RELEASED BY GAT E
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
1
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
ORIGINAL - FILE YELLOW INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER GOLD - ASSESSOR
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: _YIRE DEPARTMENT DATE
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE---
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sirrEADDREss
PERMIT #166 1 - 00 2�'/ ADB# DATEINSPECTED
DESCRIPTION OF WORK TO BE INSPECTED USr- P , fL-1�—SIC �4- c
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 BON and the granting of:
)< GRANT FINAL PROJECTAPPROVAL
GRANT PROJECT APPROVAL WrITI CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
1
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
1.
2.
3.
RE-INSpEcTED OUTSTANDING ISSUES - GRANT FINAL PROJ ECT APPROVAL
Date Si
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing . .....................
wait ..............
Pier/Porch
Retaining Wall
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Slab Insulation ..........
PLUMBING:
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Underground .............
M 0
Rough -In ...................
80
Commercial Final
171
171 z
HEATING:
10-4
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Equipment .................
commercial Final
M M
EXTERIOR SHEATHING
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NAILING ..........................
001
FRAMING
Q 0
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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