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CITY OF EDMONDS
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PLAN CHECK NO: OS I V0
VESTED DATE
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THIS PERMIT AUTHORD"a ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON I HE PUSUC
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2 DOMAN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES. OC.) wU REQUIRE
SEPARATE PERMISSION.
Engr. Review
PEAMffAPPLICATION: 180 DAYS nHiN IN DAYS
PERMIT UUm I YEAR - PROVIDED W RK IS STARTED W
Engr. Inspection
SEE BACK OF PINK PEANUT FOR MORE INFORMATION
PI.Chk.Dopwl
. F HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
'APPLICANT, ON BEHALF 0
Fire Review
Fire Inspection
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Receipt #
IN INTEREST. AGREES TO EMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EMPLOYEES. AND AGENTS MOM ANY AND
ri EDMONDS - WASHINGTON. ITS OFFICIALS
ALL CILAIM5 -11 D—GES OFWHATEVEn NATURE. ARKSING DIRECTLY OR INDIRECTLY
Total Arm. Due
FROM T. SSUANCE OF T1111 PERMIT SHALL NOT BE
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WANE RE
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NOR UNIT IN ANY WAY THE CTYS ABIUTy TO ENF RC ANY CABIN
Recording Fee
1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE NFO.RMAITJON
A ENT OF
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GIVE SWIPRECTANDTHATIAMT11E OR THE DULY AUTHORIZED
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THE OWNER. I AGREE TO COMPLY H G Sj�AT.E.ILAWS BEGULATIN
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
IN
FOUNDATION:
Footing ............
Wall ..........................
Pier/Porch .................
Retaining Wall ...........
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Slab Insulation ..........
PLUMBING:
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GasTest ....................
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Gas Plping .................
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NAILING ....................
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FIRST FLOOR FRAMING
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Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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DATE RECEIVED
PERMITEXPIRES
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CONSTRUCTION PERMIT APPLICATION
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LLA -nON
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Description
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Description
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HEAT SOURCE GLA,iDNG % LOT SLOPE %
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City Surcharge
PLA14 CHECK NO: VE STED DATE
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THIS PERUIT AUTHORUDES ONLY THE WORK NZI THIS PERMff COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DONLAN! (CURSE, SIDEWALKS, DRIVEWAYS, MMQUEES, ETC.) WuLl REQUIRE
SEpAnArEPERMISSION.
Engr. Review
PIERMrTAPPLICATI N: 150DAYS
PSSMff UMM. I YEAR - PRO%1 ED WORK 13 STARTED VrITHIN ISO DAYS
ETg,. Inspection
SEE BACK OF PINK PERUM MR MORE INFOR"TlON
'"PUCANT. ON BEHALF OF . HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Rwi— It—?()
— PI.Chk.DBpd
IN INTEREST, AGREES TO INDE.N11 DEFEND AND HOLD H
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EDMONDS WASHINGTON. ITS OFFICUU_S. EMPLOYEES. AND AGENTS MOM ANY AND
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ALL CLAIM� FOR DMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
BE
FROM THE ISSUANCE al THII PERMIT ISSUANCE 01 THIS PERMIT SHALL NOT BE
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SP.
Total Am, Due
IC
DEEMED TO MODIFY. W� OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE
NOR UNIT IN AM WAY THE DAYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
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Recording F�.
Recording F�.
R..elpl II
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVA L
GPVEN IS CORRECT. AND THAT I A14 ER OR THE DULY ORIMD AGENT OF
T"' ppllcaw� I, n., . p-r-ft -�Igped bY Me
THE OWNER. I AGREE TO DO LVUZIHF�Nti SETUAtT.ENLAWS REGULATING CONSTRUC-
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CALL
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IT IS UNLAWFUL T USE UPY A BUiL OR STRUCTURE NTIL
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CATE OF OCCUPANCY HAS R� U
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