20040780.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
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PERMIT EXPIRES
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GARAGE RETAINING WALL FIRE SPRINKLER
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REMARKS
PROGRESS INSPECTIONS PER UBC 108 IBC109/ IRC109 FINAL INSPECTION REO'D
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Description
FEE
Description
FEE
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Plan Check
State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE %
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Building Permit
City Surcharge /15�
PI AIQ CHECK NO: VESTED DATE
Plumbing
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Base Fee ILI
Mechanical
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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.
Engr. Review
PERMIT APPLICATION: ISO DAYS
PERMIT LIMIT1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'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, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
x ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRFC ITY 0
It R INDIRECTLY
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1: FROM THE ISSUANCE OF THIS PERMIr. ISSUANCE OF THIS PERM11 SHALT- NOT BE
Landscapelnsp.
Total Amt. Due
0 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CIFY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION
Receipt #
Recording Fe e
77
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
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 arc paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
OF
IlArS -NATURE D TE
SIG URE (OWNE AGENT�)$ DI/IGNED
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(425)
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BY DATE[
'ATf ENTION
EXT 1333
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ITIS UNLAWFULTOT USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVALOR A CERTIFICATE OF OCCU-
ORIGINAL - FILE - YELLOW - INSPECTOR
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110.
PINK -OWNER - GOLD -ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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'RECORD "OF INSPECTIONS
-_ INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Foo ting .......................
Wall..........................
�Pi orch'.* ........ .......
�etaining Wall
Sl�b.lnsulation
PLUMBING:
Underground .............
Rough -In ........ ...........
Commereijal Final .......
HEATING -
Gas. -Test .. . . ................
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
FRAMING-...,-'. .............
FIRST.,�LOOR FRAMING ...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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