20040684.pdfERMIT EXPIRES (7f
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DATE RECEIVED
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NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
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Description FEE Description FEE
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
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SEPARATE PERMISSION.
Engr. Review
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W PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT' I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
;APPLICANI, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
N INTEREST ' AGREES TO INDEMNIFY, DEFEND AND HOLD HARMIESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIAIS, EMPLOYEES, AND AGEN IS FROM ANY AND Fire Inspection
Ir Receipt III
ALL CLAIMS FOR DAMAGES OFINHATEVER NATURE. ARISING DIRFCTtY ORINDIRFCItY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALI NOT' BE
Q DEEMEDTO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due
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0 NOR LIMIT IN ANY WAY THE CirY,S ABILITY 10 ENFORCE ANY ORDINANCE PROVISION
MI Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER I AGREE TO COMPLY Willi CITY AND STATE LAWS REGULATING CONSTRUC. 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 Official or hisitier Deputy. and Fees are paid, and
IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided
WORKME��MPENSATION
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IT IS UNLAWFULTO USE OR OCCUPYA BUILDING OR STRUCTURE UNTILA FINAL
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU- ORIGINAL FILE YELLOW-INSPECIOR
PANCY HAS BEEN GRANTED. UBC109/IBC110/iRC110. PINK OWNER GOLD -ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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REC0E6_ I V E D
SEP 91 2004
DEVELOPMENT SERVIUS CIR.
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
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FROM: FIRE DEPARTMENT DATE
PIXASESIGN
ENGINEERING DIVISION DATE
PLEASE SIGN
PLANNING DIVISION DATE
PLFASE SIGN
PROJECT tzz±o- u_/1161- Z_
SITE ADDRESS —
PERMIT 66 "1 0 ADB# DATE INSPECTED
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DESCRIPTION OF WORK TO BE INSPECTED A'_5 &_ --r- c .4?'
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
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:teniP:b1dg:rorni-,:ocaprv1 3/25/04
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Re'taining'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 APPRGYAtFMR
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