20040639.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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Description FEE Description FEE
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERk WOAK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 180 DAYS
L PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 1130 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Fire Review
Plan Chk. Deposit
F) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
OF
11 '10 INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY
9 IN INTEREST, AGREES
EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
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r OR INDIRECTLY
I ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY
r THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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Total Amt. Due
FROM
3 DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
Recording Fee
Receipt #
1:
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application is not a permit until signed by the
his/her Deputy: Fees
THE OWNER, I AGREE TO COMPLY WITH
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
RELATING TO
FOR INSPECTI ON
Building Official or and are paid, and
receipt is acknowledged in space provided,
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
WORKMEN'S COMPENSATIO��NCE AND RCW 18 27.
OF Tell DATE
NER DATE Sl
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BY DATE
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ATTENTION a"I"k , x
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-INSPECTC
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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GARY HAAKENSON
CITY OF EDMONDS MAYOR
121 5TH AVENUE NORTH - EDMONDS, WA 9BO20 - (425) 771-0220 FAX (425) 771-0221
Website: www.ci.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning Building Engineering
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June 16, 2004 0
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Connie & Henry Grenley
20505 86th Pi W
Edmonds, WA 98020 M�
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ent building codes C
RE: Vesting current plan review #04-207 under the curr
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We are writing to remind you of the City adoption of the International Building Codes effective
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July 1, 2004 to vest your application under current codes. The amount to vest your application is
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d fees in the amount listed above are not received BEFORE July 1, 2004 your plans M 0
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must be returned to you and any fees paid to date must be forfeited.
If you have any questions please don't hesitate to contact the permit coordinator assigned to your
project at 425-771-0220. z
Sincerely; C/)
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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
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AEASIT-SIGN
PLANNING DIVISION DATE
PLEASE SIGN
PROJECT—&i(U 1em
SITE ADDRESS 5-y X- pl
PERMIT# ADB#__�__DATE INSPECTED V-00/03
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DESCRIPTION OF WORK TO BE INSPECTED
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
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fbn-ns:ocaprv1 3/25/04
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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 ..........................
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FRAMING ........................
FIRST FLOOR FRAMING ...
INSULATION ...................
L,
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
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SHEETROCK NAILING ...
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SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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Tile initials MT are Milton
Thompson, a temporary contract
inspector for the City.
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