20040031.pdfI
DATE RECEIVED 61 PERMIT EXPIRES
USE PERMIT
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id _�( 1 :5//) Lj PLAT NAME/SUDDIVISION NO. LOT NO. LID NO.
cc MrrING ADDRESS LID FEE $
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CITY ZIP TELEPHONE EXISTING — PROPOSED Siclawalk Required E3
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NAME METER SIZE LINE SIZE NO� OF FIXTURES PRV REQUIRED
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.1-U===ZL Description FEE Description FEE
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ECK NO: VESTED DATE Plumbing Base Fee
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
2 Engr. Review
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uj PERMIT APPLICATION: ISODAYS
IL PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHAI F OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND Hot D HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OFWIiATEVFR NAIURE,ARISiNGDIRECIIYORINDIRECTiY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due
0 NOR LIMIT IN ANY WAY THE ciryS A131LIlY TO ENFORCE ANY ORDINANCE PROVISION."
Recording Fee Receipt #
I I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREETo COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application is not a pennit until signed by the
CALL
TION; AND IN DOING THE WORK AUTITORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and
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IN VIOLATION OF THE LABOR CODE OF TliE STATE OF WASIIINGTON RELATING TO FOR INSPECTION receipt is ackno . wledged in space provided.
WORKMEN'S COMPENS��CE AND RCW 18 27
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SIGNATUIR DAT SIGNED
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771-0220 ELEA ED B
ATTENTION I rg�j E)ff 1333 ATE
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 GOLD - ASSESSOR
09/03 NOP,
PRESS HARD -YOU ARE MAKING 4 C
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ......
HEATING -
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final .......
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XTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING ...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
The initials DAW a,, David
Wilson, a ten',porary contract
inspector for the City.
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