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PROGRESS INSPECTIONS PER UBC 108/IBC1091IRC109 FINAL INSPECTION, REQ'D
VALUATION
Description FEE Description FEE
u�'\/ jj!EE� Plan Check A/ StateSurcharge �zo
HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge
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PLAN CHECK NID- VESTED DATE Plumbing Base Fee
I N I Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: 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: 160DAYS
PERMIT LIMIT. I YEAR I 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 #
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.X ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIE ISSUANCE OF ITHIS PERMIT SHALL NOT BE
0 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CI1Y ORDINANCE Landscapelnsp. Total Amt. Due
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0 NOR LIMIT IN ANY WAY THE CHYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
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1 Recording Fee Receipt # Z5 &2-C,-;
1 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 WITH CITY AND STATE LAWS REGULATING CONSTRLIC- 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/tier Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WUHKMtN'ti L; MPENSATION INSURANCE AND RCW 18.27.
0) F I VC�IA /I U DATE
6N4T) DATE SIGNED YIGNAT
SIGN��ZWN . E - n ENTI) 425)
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771-0220 REI. E AT
ATTENTION EXT 1333
IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL 1—n - 1( 1(( ((/ I
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCU- 0111GINAL - FILE YELLOW INSPECTOR
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110. J PINK - OWNER GOLD - ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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(206) 617.749410)6) 364.07"
FINAL PROJECT APPROVALTORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUKDING DIVISION
FiRE DEPARTMFINT DATE—___�
..FROM:.
ENGINEERINGDIVISION DATE__�1�1'66�.
PLANNING DIVISION DATE____�
PROJECT___��
SITE ADDRESS___� 7, 7 Z<) b!W.' 6,ti
ADB DATE.INSPECTED
PERMIT# MJ4
DESCRIPTION OF WORK TO -BE INSPECTED
A fleld inspection was conduicted to determine rinal compliance with.approved plans. Final approval
denotes that . there an no objections from the above signed Department to the release of
PERFORMANCE. BONDS and the granting of
GRANT FINAL PROJECT APPROVAL
GRAM pROJECr APPROVAL WrrH CONDITIONS NOTED
(3 Copy of CONDMONS given to . owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
Co' ofCORRECMON NOTICE given to owner/contractorby inspector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL,
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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 ..........................
FRAMING........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL IN SPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
The initials MT are Milton
Thompson, a temporary contract
inspector ror tile City.
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