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CITY OF EDMONDS ZONE N IIE I
CONSTRUCTION PERMIT APPLICATION Joe St_ 111TEIPTI
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FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE LOT SLOPE
Building Permit City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHCR�S ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUDUC
Grading
DOMAIN (CLASS, SIDEWALKS. DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review,
PERMRAPPUCAIION IWDAYS
PERMIT UMM. I Y4EM. PROW ED WORK IS STAITTED WITHIN I.DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APP1ICwL ON BEHALF OF 115 OR HER SPOUSE, HEIRS, ASSIGNS AND 110CEIORS
Fire RevieW Plan Chk. DePoGI
IN INTEREST, AGREES TO INDEMNIF�. DEFEND AND HOLD HARMLESS THE CITY OF
ED MONDS . WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AOENTS MOM ANY AND
Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapelnsp. Total Amt. Due
DEEMED TO MODIFYkWAIVE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE
it NOR LIMIT IN ANYW Y THE CITYS ADI Y TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee Receipt N _70
I HEREBY ACKNOWLEDGE THAT I HAVE a. THIS APPLICATION. THAT THE INF RMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, a THE OUILY AUTHORIZE AGENT 01
WITH CITY AND STATE LAWS HE GULAT'NG CONSTRUC
THE OWNER I AGRE'V
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TION; ORK DRIZED THEREBY. NO PERSON WILL BE EMPLOYED
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THE TATE OF WASHINGTON RELATING TO
FOR INSPECTION .,A..�.dg.d ..p ... pl.Med.
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771-0220 `FELEA7P By DATE/
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EXT 1333
TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK.OWNER 0 LD-ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ..............
,FOUNDATION:
FbotiAg . ........ ... ............ ...
Wall..........................
PlartPorch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
2-3
Rough -in ...................
AS
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Gas Piping .................
Equipment .................
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Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING........................
FIRST FL900 FR,�MING
L Tid ...................
'Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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Description
FEE
Description
FEE
Plan Check
State Surcharge
GLAZING LOT SLOPE %
Pudding Peanit City Surcharge
PLAN CHECK NO:
Pltunblrig
Mechanical
THIS PEnMff AUVKORM ONUf THE WORK NOTEG. THIS PERMIT COVEn WORK TO
BE DONE ON PRIVATE pROPEFTY OHM ANY CONSTRUMON ON THE PUBUC
Grading
DOMAMN JCURBS, sioEwALKS, ORRI MJU1 UEM, ETC.) WILL REQUIRE
SEP�JE PERMISSION.
Engr. ReView
P_ "n' ON: T_
UNIT PROVIDED WORK 15 STARTED WITHIN IWDAYS
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F P�
Engr. Inspection
1. BACK'CiPINKIPERMIT MR MORE INFORMATION
ON BEH� HIS OR HER SPOUSE, HEIM. ASSIGNS AND SUC ESORS
Fire Review PlanChk.DepoEt
;APPLICANT.
N INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
ANY AND
Fire Inspection Receipt N
EDMONDS. WASHINGTON, 98 OFFICLALS, EMPLOYEES. AND AGENTS MOM
ALLCLARAS FOR DAMAGES OFWHATEVER HATURE.ARISINGIDIRECTEYORINDMIECTLY
FR M THE ISSUANCE OF THIS PERMIT. ISSUANCE Of THIS PERMIT SHALL NOT BE
Landscape Insp. Total Aint. Due 12LL227-
DEEMED TO MODIFY WAVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
N W/� -a
21
Recording Fee Receipt
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPILICATION; THAT THE INFORMATION
APPLICATION APPROVAL
EVEN IS CORRECT. AND THAT I AM THE OWNER. OR 11 OU, AUTHORIZED AGENT .1
THE CMNE AG AND STATE LAW S REGULATING CONSTRUC-
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ALL IN, PpIl.— 1. n. . .I, iI,1p.d by
C d,g MCW 0, NsIher �,,Viy: Md IR,0S — p�. �d
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IROH; AND IN D THEREBY NO PERSON WILL BE E
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RE�TING TO
FOR INSPECTION .... I, I, aaWg� pac, pmidO,
IN VIOLATI . OF THE STATE OF WASHINGTON
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771-0220 BY
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EXT 1333
IS TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK-OVNER - G LD.ASSESSOR
GREEN . ACC HTING
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