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FPERMIT EXPIRES
USE PERMIT Y -71-'Iq
CITY OF EDMONDS ZONE NUMBER 0
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OWNER.�AME/NAME OF BUSINESS
zPLAT NAME/SUBDIVISION NO. LOT NO. LID NO.
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3: zr� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Rvy Permit Requited 13
0 _$jjgVjLfJ.%&RQ&Fq Req'd 0
CITY ZIP TELEPHONE EXIST�NG inspection Required 13
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VALUATION
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!Lee) Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge
PLAN CHECK NO: VESTED DATE Plumbing 7�, Base Fee
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
Engr. Review
Lu PERMIT APPLICATION: IBODAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) '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 THE CITY OF
2 EDMONDS, WASHINGTON, IrS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHAFEVER NATURE, ARISING DIREcnYOR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF 1HIS PERMIT SHALL NOT BE
cl DEEMED TO MODIF714 WAIVE OR REDUCE ANY REQUIREMEN1 OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due nZ
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X1 NOR LIMIT IN ANY WAY THE CITYS ABILITY 10 ENFORCE ANY ORDINANCE PROVISION.* Recording Fee Receipt # L -
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR 1fIE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OFqHE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S/C,e&PNSATION INSURANCE AND RCW 18.27.
OFFICIAL5 S GNAT RE D T
IGNATUR NER AGENT) DATE SIGYED (425)
771-02,20 REL9ASFD BY /DATf—
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ATTENTION EXT 1333
IT IS UNLAWFULTO USE OR OCCUPYA BUILDING OR STRUCTURE UNTILAFINAL ---
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCU- ORIGINAL - FILE YELLOW - INSPECTOR
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110- PINK -OWNER GOLD-ASSESSOn
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ................ z
0
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING: M
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Uhderground ............. M 0
0
0 C
Rough -In ................... —4 r.
X M
Commercial Final ...... M Z
HEATING: c w
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Gas Test .................... _vn
Gas Piping ................. 0 _n
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Equipment ................. 3:9
M M
Commercial Final ....... 0
0
0 M
EXTERIOR SHEATHING C Cn
NAILING .......................... 90)
Q 0
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FRAMING ........................ .1
FIRST FLOOR FRAMING ... ;0
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INSULATION ................... >
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Floor Insulation ......... -4
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Wall Insulation ...........
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Ceiling Insulation ....... —i
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SHEETROCK NAILING ... M
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR VV'\
OCCUPANCY ..................
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