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RMIT EXPIRES
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USE PERMIT
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CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
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-Description FEE Description FEE
Plan Check State Surcharge '17�5e�
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Building Permit City Surcharge
PLAN CHECKn
VESTED DATE Plumbing Base Fee
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THIS PERMIT AUTHORIZES ONLY THE f WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical
I= 13E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 180 DAYS
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PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) OAPPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk.
fA Deposit
W IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS rilE Cl
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2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection
tr Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT
ISSUANCE OF THIS PERMIT SHALL NOT BE __P_
DEEMED I'D MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due
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NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee Receipt # kv�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION 14LL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRLIC- This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL Building Olficial or his/tier 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
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
OFFICIAI,&�-�31103N 'T,� DATE
S �IUR�A�ERI ENT)_ DATE SIGNED (425) X
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771-0220 By
REI!EASED 13Y DATE
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ENTION E)ff 1333
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,.:bWNER GOLD - ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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RECEIVED
MAR 2 9 2004
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APPHOVED AS NOTEL
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SITE ADDRESS:
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24132 106th Place W.
Edmonds, WA
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GARY HAAKENSON
CITY OF EDMONDS MAYOR
121 5TH AVENUE NORTH - EDMONDS. WA 98020 - (425) 771-0220 - rAX (425) 771-0221
Website: wwadedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
November 16, 2004
Attn: Alan & Miclicle'Hollingsworth
24132 106th PI W
Edmonds, WA 98020
Building Permit: 2004-0293
Site Address: 24132 106th PI W
Expiration Date: 4/22/05
Dear Alan & Michele Hollingsworth:
The purpose of this letter is to inform you that the last remaining inspection oil your
project is a final inspection(s). The final inspcction(s) determines that there are no
outstanding life -safety issues and approval allows the City to close your pen -nit file.
The City considers the final inspection to be one of the n-lost important inspections
conducted oil a project. In order to grant final approval the following must be complete:
smoke detectors, house numbers, guardrails, liandrails, self -close doors between garage
and residence, egress from sleeping roorns, safety glazing, weather-stripping, any
Engineering department requirements etc. Of course not all orthese 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 iterns 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
pernlit 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 Oil Your Job Card.
Please feel free to contact me at 425-771-0220 if you have any questions.
Sincerely,
Permit Coordinatoi
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Incorporated August 11, 1890
Sister Citv - Hekinan. Janan
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FINAL PROJECT APPROVAL FORM
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: -FIRE DEPARTMENT DATE
PLEASE SIGN
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FAMED FINAL INSPECTION - OUTSTANDING ISSUES
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:tenip:b1dg:fbrms:ocaprv1 3/25/04
RECORD
OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Stab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ......
HEATING:
Gas Test ....................
GasPiping .................
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Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FRAMING
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FIRST FLOOR ...
INSULATION ...................
Floor Insulation ...
Wall Insulation ...........
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Ceiling Insulation .......
SHE I ETROCK NAILING ...
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SPECIAL INSPECTION ...
MISCELLANEOUS ...........
FINAL APPROVAL FOR
OCCUPANCY ..................
20oqXZq, 3
The initials MT are Milton
Thompson, a temporary contract
Inspector for tile City.
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