20040789 (2).pdfI
DATE RECEIVED
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[PERMIT EXPIRES'
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CITY OF EDMONDS
USE E/ PERMIT
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CONSTRUCTION PERMIT APPLICATION
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inspection Required E3
sidewalk Required E3
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NO. OF FIXTURES
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REMARKS
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REMARKS
DEMOLISH TANK OTHER
GARAGE FIETAININGWALL FIRE SPRINKLER
El FIRE ALARM
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(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
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PROGRESS INSPECTIONS PER UBC 108/IBC109/ IRC109 FINAL INSPECTION REQ'D
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Description
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Plan Check
State Surcharge
HEAT SOURCE
GLAZING %
LOT SLOPE %
Building Permit
City Surcharge
Plumbing
Base Fee
PLAN CHECK NO: VESTED DATE
Mechanical
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.
Engr. Review
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PERMIT APPLICATION: 180 DAYS
13.
PERMIT LIMIT 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Fire Review
Plan Chk. Deposit
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt 9
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
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FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
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Total Amt. Due
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DEEMED TO MODIF'� WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Recording Fee
Receipt #
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NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLIC ATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE 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
V11^1 ATInM OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
I=nR 1NqPF=rTION
Building Official or his/her Deputy: and Foes are paid, and
receipt is acknowledged in space provided.
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WORKMEN'S COMPENSATIP,�.-INS'URANCE AND RCW 18.27. OFFICIA
DATE S NED (425)
771-0220 ( REL S
EXT 1333
IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVALOR A CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/[BC110/IRC110.
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
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Retaining Wall ........... 0
Slab Insulation .......... 0
PLUMBING:
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Underground ............. — --I
0 M
Rough -In ................... C 0
M 0
—1 0
Commercial Final ......
0 f-
HEATING:
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Gas Test ....................
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Gas Piping ................. r— --i
Equipment ................. C/)
0 -n
Commercial Final ....... -n
EXTERIOR SHEATHING M M
NAILING..........................
0 C/)
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FRAMING ........................ 171
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FIRST FLOOR FRAMING ... Q 0
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INSULATION ...................
Floor Insulation .........
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Wall Insulation ........... z
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Ceiling Insulation .......
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SHEETROCK NAILING ... z
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SPECIAL INSPECTION ...
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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