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Description FEE Description FEE
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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 Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
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0. PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
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IN INTEREST, AGREES 1*0 INDEMNIFY. DEFEND AND HOLD HARMLESS THE 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 INDIREC I LY
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF IHIS PERMIT SHALL NOT 13E Landscapelnsp. Total Amt. Due :�77
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Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMAI ION APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF I his application is not a permit until signed by the
THEOWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC�� CALL Building Official or hisilier Deputy: and Fees are paid, and
TION; AND IN DOING TIiE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMP,
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING 0 FOR INSPECTION receipt is acknowledged lit space provided
WORKMEN'S CC,��SATION INSURANCE AND RCW 18 27. DATE
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SIGNATURE WNER AGENT) DATE SIGNED (4125)
771-0220 iRELEASE6 9 E(ATE
ATTENTJbN EXT 1333
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INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU- ORI(IINAL - FILE YELLOW - INSPECTOR
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0. PERMIT LIMI*P. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
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U) `APPLICANI, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt 0
ALI. CLAIMS FOR DAMAGES OF WHATEVER NAI URE, ARISING DIRECI IN OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT 8E Landscapelnsp. Total Amt. Due
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IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING To FOR INSPECTION receipt Is acknuyylu0gc0 in space provided
WORKMEN'S PGMP�NSATION INSURANCE AND RCW 18.27, OFFICIALS SIGNATURE DATE
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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 .................. /777-
The Initials MT are Miltol,
Thompson, a temporary contract
inspector ror the City.
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