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*14- PERMIT EXPIRES
US F� PERMIT
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CITY OF EDMONDS NUMBER
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CONSTRUCTION PERMIT APPLICATION ADDRESS
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WAY-711 OFFICIAL STREET MAP IFSCP Approved
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L) OWNER/CONIRACIOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
CITY ZIP TELEPHONE
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NAME CBL# %1jelf Or Closed, tmparisjun tanks are
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STATE LICENSE NUMBER EXPIRATION DATE I CHECKED BY
PROPERTY TAX ACCOUNT PARCEL NO,
NEW RESIDENTIAL PLUMBING / MECH
COMPLIANCE OR
ADDITION COMMERCIAL CHANGE OF USE
REMODEL MULTIFAMILY SIGN
GRADING FENCE
REPAIR F-1 CYDS I X FT)
DEMOLISH 13 TANK 0613's'
GARAGE RETAINING WALL FIRE SPRINKLER
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(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
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DESCRIBE WORK TO BE DONE
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PLAN CHECK NO: I VESTED DATE
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
SEPARATE PERMISSION.
PERMIT APPLICATION: 180DAYS
PERMIT LIMIT 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
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W IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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2 EDMONDS, WAS HINGTON, ITS OFFICIAIS, EMPLOYEES, AND AGENTS FROM ANYAND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING OIRECTIYOR INDIRECII-Y
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOr BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
01 NOR LIMIT IN ANY WAY THE CITYS ABILITY FO ENFORCE ANY ORDINANCE PROVISION.-
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
GIVEN IS CORRECT; AND 111AT I AM THE OWNER. Oil THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE 10 COMPLY Willi CITY AND STATE LAWS REGULATING CONSTFILIC-
TION ' AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18 27,
SIGNA4fRf a"R+-0ff`AQENT) , I DATE SIGNED
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SPECIAL INSPECTION JAREA OCCUPANT
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REMARKS
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[PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D zi
VALUATION
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
CALL
FOR INSPECTION
(425)
771 -0220
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FEE Description
State Surcharge
City Surcharge
Base Fee
FEE
Plan Chk. Deposit
Receipt # _X_�
"77--
Total Amt. Due
Receipt #
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APPLICATION APPROVAL
I his application is not a permit until signed by the
Building 011icial or his/her Deputy: and Fees are paid, and
receipt is acknowiLdged in space provided.
-F I ISIGNATU E D �'r -
1 rASFD 13Y DATE'
09!03 PRESS HARD -YOU ARE MAKING 4 COPIES
0141GINAL FILE YELLOW, INSPECTOR
PINK -OWNER GOLD -ASSESSOR
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RECORDIOF INSPECTIONS
INSPECTOR DATE APPROVED
SETJBACI(� ............
FO.UNPATION:
Footing'...� ...................
Wall ..........................
Pier/Porch .................
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Slab ln��I�flon...*
PLUMBING:
Underground .............
Rough -In ....................
Oor6eridi a*I Final
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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