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CITY OF EDMONDS ZONE
CONSTRUCTION PERMIT APPLICATION JOB
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STATE LICENSE NUMBER
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COMPLIANCE OR
ADDITION COMMERCIAL 11 CHANGE OF USE
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REMARKS IS
PROGRESS INSPECTIONS PER USC I 0B/FINAL INSPECTION REOD
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Plan Check State Surcharge
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P. I City Surcharge
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PLAN CH STIED DATE
Plumbing
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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c BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON In 9 BLIC
OMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
Grading
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: ISODAYS
PERMIT LIMIT I YEAR. PROVIDED WOR IS STARTED WITHIN 1110 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review Plan Chk, Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLE S THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM AN AND
YOTLY
Fire inspection Receipt N
A RE
'1LCLAI.S1CR-.A.ES.1-.ATEVER NATURE.AR1.IN.DI.EC1-..I..I
ROM THE ISSUA CE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF My CITY ORDINANC
Landscapelrep. Total Amt. Due
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0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Recording Fee Receipt # LL
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN Is CORRECT. AND THAT I A. THE OWNER. a THE DULY AUT14OR ZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
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TION; AND IND I MPIOYID
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ding Official or hisdee Depay and Fees are paid. and
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IN VIOLATION OF THE ST F WASHINGTON RE ATING TO
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WORKMSNS.POMPENS NO AND HOW 18.27.
FOR INSPECTION Ire 1p.of PId�d'
OFFICIA 6 S!GNAFURE
DATE SIGNED
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771 -0220 DATE
ATTENTION
EXT 1333
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 - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER GO �ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ...................
FOUNDATION:
Footing .............
wall .....................
PledPorch
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Relaining.Wall ........... 777-
M
Slab Insulation ..........
PLUMBING:
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Underground .............
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Rough -in ...................
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Commercial Final
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HEATING:
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Gas Test ..� ..........
Gas Piping _ ...............
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Equipment ................
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Commercial Final
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0
EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING.......................
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FIRST FLOOR FRAMING...
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INSULATION ................
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Floor Insulation
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Wall Insulation ...........
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Gelling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR 4�3