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THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
Recording Fee
2 DOMAIN (CURBS, SIDEWALKS, DRIVIEWAYS, MARIQUEEB. ETC.) WILL REQUIRE
3
SEPARATE PERMISSION.
Engr. Review
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City Surcharge
PERMITAPPLICATION: 1180DAYS
PERMIT UUM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS
Engr. Inspection
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State Surcharge_
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
N BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
;APITr
N "REjTO AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS 1 HE C1 17 OF
AND
Receipt #
EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY
Fire Review
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE IS'SUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Fire Inspection
tal Amount Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
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Receipt #
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I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This applicatIon is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt Is acknowledged In space provided.
WORIyA5NS C 'ENSATII>,INSU CW 18.27.
RANCE ANY R
OF CIALS SIGNATURE DATE
DATE SIGNED
(425)
-dATE
771-0220
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IT IS'dNLAWFU 0 E OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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771-0221
A FINAL INSPEC N HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - Fl&,/ YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
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CITY OF EDMONDS
121 STH AVENUE NORTH * EDMONDS, WA 98020 * (425) 771-0220 9 FAX (425) 771-0221
Website: wwdedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building 9 Engineering
September 19, 2003
Attn: Todd Jacob
18720 81st Ave W
Edmonds, WA 98026
:Building Permit: 2003-0285
SiteAddress: 1872081stAveW
ExpirationDate: 4/18/04 ,
Dear Todd Jacob:
GARY HAAKENSON
MAYOR
The purpose of this letter is to inform you that the last remaining inspection on your
project is a final inspection(s). The final inspection(s) determines that there are no
outstanding life -safety issues and approval allows the City to close your permit file.
The City considers the final inspection to be one of the most important inspections
conducted on a project. In order to grant final approval the following must be complete:
smoke detectors, house numbers, guardrails, handrails, self -close doors between garage
and residence, egress from sleeping rooms, safety glazing, weather-stripping, any
Engineering department requirements etc. Of course not all of these things may
specifically apply to your project but it does give you an idea about the kinds of things
that must be complete as well as some items that do not need to be installed such as:
paint, carpet, moldings, wallpaper, etc. Please be advised permits expire one year from
the date of issuance. If you will need more time to complete the work, permits can be
renewed prior to expiration for one half fees. If the permit expires without a final
approval granted by the Building Inspector, full fees are required in order to renew the
permit. This can be very costly to you and we strongly encourage you to check your
permit expiration date and call for the required final inspection(s). Note: If more than
one department is required to final your project, this is noted on your Job Card.
Please feel free to contact me at 425-771-0220 if you have any questions.
Sincerely,
PeZ�L or
Incorporated August 11, 1890 0
Sister City - Hekinan, Japan
iFINAL PROJECT APPROVAL FORM
TO:
DATE:
t
3.
RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
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JOB #
CONSTRUCTION PERMIT APPLICATION ADDRESS j 5�
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OWNER NAM7E OF BLIMIP&S
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PROPERTY TAX ACCOUNT PARCEA, NO
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COMPLIANCE OR
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0 DEMOLISH [3 TANK [3 OTHER
WARAGE [3 RETAINING W ALL
CARPORT ROCKERY [3 RENEWAL
CrYPE OF UM tUSINE88 OR ACTIVrM EE0PLAIN
NUMBER
NUMBER OF
RITICAL
CREAS
OF
DWELLING
STOLRIES
UNITS
DESCRIBE WORK TO BE DONE
77
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PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
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___
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLjDFWNAGE
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REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RaWD
VAWATION $
Description FEE
�..,,Dewriptllon FEE
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IGLAZING % LOT SLOPE Building
-OLI 0 [Too
PLAN CHECK NO- VESTED DATE Plumbing
a2 a:z-.2 Mechanical
THIS PERMrr AUTMHMMS ONILY THE WORK NOTED. THIS PERMIT COVERS WORK TO
r_
I&E DONE ON PRIVATE PROPERTY ON ANYCONMUCTIONONTHEPUBLIC
Grading
Recording Fee
DOMN (CURBS, SIDEWALKS, DRIVIEWAVS, MAMMEES, ETC.) WILL REQUIRE
SEPARATE PEWISSION.
Engr. Review
City Surcharge
PERMITAPPLICAT11W 180 DAYS
PERuff umm i yam - PutoviDED wdRK'18 sTAffmD WITHIN 180 DAV8
Engr. Inspection
/0/
State Surcharge
1460
BEE BACK OF PINK PERMIT FOR MORE INFORMATION
T-ffl,r,l LAM fl,r,,n
Plan Chk Derjoall:
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'APPLICANT, ON BEHALF OF 148 OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST. AGREES TO INDEMNIF% DEFEND AND HOLD HARMLESS THE CITY Or
EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIREC11Y OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMM ISSMANCE OF THIS PERMIT SHALL NOT BE
Total Amount Due
rq
Fire Inspection
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINA14CE PROVISION.-
Landscapainsp]
Receipt #
C91
I HER&Y AOMWLED13E THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN 48 PORREM AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE O0jN91L I AGREE 1-0 COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
TWz application is not a permit ur" siwied by the
TION; AND'IN DOING THE WORK AUTHORIZED THEREIYY NO PERSON WILL BE EMPLOYED
EkAdkV Official or hMm ooputy� and Fees are Paid. and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
rec*t is acknowadged in space ptoviclad.
Wo" 8AT* NSURANCE ANY RCW` la.27
OF CIALS SIGNATURE DATE
AG
DATE SIGNED
IA40
34UA k
�B
771-02 2-V
RELEASIE'p Y DATE
10
'0CCUPY11'BU`1LDING
Off 1333
IT IS NLAWFU 0 E
OR STRUCTURE UNTIL
"IF71-0221
L-
A FINAL INSPECT N HAS BEEN MA : AND APPROVAL OR A CERTIFI-
ORIGINAL - F]Li---- YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
10/01
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