20040468.pdf11 DATE RECEIVED/
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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REMARKS
OWNER CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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REVIEWEDiDATE
DATE
VARIANCE OR CU SHORELINE OR ADBu INSPECTION BOND
REO'D POSTED
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT: I 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 AN[I'-AJC:CLSORS
IN INTEREST AGREES TO INDEMNIF�. DEFEND AND HOLD HAR?JLE�F I iii C11 Y 01
EDMONDS, WASHINGTON, ITS OFFICIALS. FrA11LOYFES ANDAGENTSF-�40"IA A%, AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NAT URF. ARISING DIrIFC1 L'V 01; Cl'_�
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PEP".111' SHALL NOT FIE
DEEMED TO MODIFY, WAIVE OR REDUCE ANYRECUIRKMENT OF AN", ('11 , OLIOINANCE
NOR LI%IIT INANY WAY THE CITY S APILI Ty 10 ENFORCE ANv ORDINANCE' PROVISInN
I HERELYACKNOWLEDGE THAI I HAVE qE AD I HIS APPLICA1 ION THAT THE INFORMA110%
GIVEN IS CORRECT AND I HAT I AM I HF OWNER OR I HE DU1',' AUTIIORI� E D AOEN I O�-
THEOWNER
TION AND IN DOING THE WORK AU I I) I f I'-- R F F Y N 0 P �_ F4 F10 N i".' I P Y F`_ 0 11 -'. 1)
IN VIOLATION OF THE LABOR CODE OF THE S'AIF OF %VASIII%GI0,N PF� Ali%i; 10
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IT IS UNLAWFUL TO USE OR OCCUPYA BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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SPECIAL INSPECTOR AREA OCCUPANT
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REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D1 190,
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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 .......
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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