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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t= 13E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
2 Engr. Review
PERMIT APPLICATION: 11110 DAYS
PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN loo DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS I HE CITY OF
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECILY
FROM THE ISSUANCE OF 1 HIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMEN r OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due 4�
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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Recording Fee Receipt # .1
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I HEREBY ACKNOWLEDGE THAT I HAVE READ TiiIS APPLICATION THAT THE INFORMATION
APPLICATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OIL THE DU& AUTHORIZED AGENT OF APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- I his application is not a permit until signed by the
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Oflicial 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.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18 27.
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DATE
SIGNATUPE A ENT) DATE SIGNED (4251
LOWNER�1)2
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771-0220 REI E'ASED Bq
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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- ORIGINAL - FILE
YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425),771-0221
Website: www.d.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
It? C. 1 o", Manning - Building - Engineering
June 1, 2004
Massoud Khami
9307 2201h Street SW
Edmonds, WA 98020
Dear Mr. Khami:
GARY HAAKENSON
MAYOR
Today a house mover came in to our office to apply for a house move permit. I asked
him where the foundation plans were. He informed me that you told him you would have
a permit numb6r for him tomorrow. I have searched our applications on file and do not
have an application for a foundation permit. I had to turn the house mover away.
Please submit an application for your foundation permit. A complete submittal includes
three site plans, two sets of foundation plans, drainage plans and height calculations. We
will also need your contractors bid for the foundation permit. You will need to submit a
bond in the amount of the contractor's foundation bid.
Once you submit for your foundation plan, your house mover may submit for the house
moving permit. The house mover will need to submit a $2,000.00 bond. The house
move permit will be issued on the same day the foundation permit is issued.
Sincerely,
tReN-mx *s4,V�
Permit Coordinator
Incorporated August 11, 1890
Sister City - Hekinan, Japan
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FINAL PROJECT* APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: -FIRE DEPARTMENT DATE
PLEASE SIGN
_f A ENGINEERING DIVISION DATE?J
-4PLEASE SIGN
PLANNING DIVISION DATE
PLEASE SIGN
PROJECT b
SITE ADDRESS
PERMIT ADB# DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED (WAO
A field inspection was conducted to determine compliance with -approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Signature
1:temp:b1dg:forms:ocaprv1 3/25/04
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RECORD OF INSPECTIONS
DATE APPROVED
INSPECTOR
SETBACKS .....................
FOUNDATION:
1� Pboting ......... �!�
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ..................
Commercial 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 ...
PECIAL INSPECTION ...
U
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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