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PERMIT EXPIRES
PERMIT
CITY OF EDMONDS
1. E NUMBER
JOB 5UIIEIAPTI
ADDRESS
CONSTRUCTION PERMIT APPLICATION
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REMARKS
OWNWHICONIBACTOR AFSPONSAIIIE FOR EROSION CONTROtIDRAINAGE
CITY
NAME
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ADDRESS
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- ---------- Mechanical 40
THIS PERMIT AUT ORIZES ONLY THE WORK NOTEM TH S PERMIT COVERS WORK TO
t HE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading In
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION. Engr. Revie.
at
15 PERMIT APPLICATION: 18B DAYS
PERMIT LIMIT I YEAR - PROVIDED WORK IS BTAMED WITHIN Lao DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLAC NT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire ReView Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CRY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AN AGENTS FROM ANY AND Fire Inspection Receipt #
OF NATURE, ARISING DIRECTLY OR INDIRECTLY
IALL CLAIMS FOR DAMAGES WHATEVER
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp.
Ake
0 D
N=T0 MODIFV�YWAAIE OR RE UCE ANY REQUIREMENT OF ANY CITY ORDINANCE
91 IN ANY IN THE CJWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
I Recording Fee Receipt #
I HERE Y ACKNOWLEDGE THAT I HAVE REA. THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
CONSTRUC-
THE OWNS . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING
CALL
IN DOING THE WORK AUTHORIZED THEREBY. A PERSON WILL BE EMPLOYED ding Offisi.I.,hialhar D.Fnay: a F .. Ina paid. and
TION; AND
VIOLATI N OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION dcaRt Is a,k,aVIPdg,d I —pace wfldod.
WORKMEN'S COMPENSATION INSURANCE AMD AGIN 18,27. OFFICIALS SIGNATURE DATE
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73/ 771-0220 DATE
VOLk
A TTENTION / / EXT 1333 adlolliA., k1ki
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR GINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 P�NK�Oi GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall
Pier/Porch .................
Retaining Wall ...........
z
Slab Insulation ..........
0
PLUMBING:
Underground .............
Rough -in ............
0
ITI
Commercial Final
M
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HEATING:
0 0
C:
MGas
Test ...................
M
Gas Piping
Equipment .. ...............
Commercial Final
0
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EXTERIOR SHEATHING
NAILING .... .....................
M ITI
0 ra
FRAMING .......... .............
0
0 M
FIRST FLOOR FRAMING..,
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INSULATION ...................
M 0
Z
Floor Insulation
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Wall Insulation ...........
3:
Ceiling Insulation
z
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3:
SHEETROCK NAILING
W
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SPECIAL INSPECTION
0
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..........
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