20040815.pdfv
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DATE RECEIVED &
PERMIT EXPIRES
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USE PERMIT
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CONSTRUCTION PERMIT APPLICATION J013 RESS SUITE/APT#
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// 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: 180DAYS
PERMIT LIMIT., I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
in 'APPLICANI. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
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Lu IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHAT EVER NATURE, ARISING DIREC f LY OR INDIRECI I-Y
X FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF IHIS PERMIT SHALL NOT 13F
a Landscapelnsp. Total Amt. Due
_j DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENTOF ANY ci ry ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION'
x 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 DU& AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC This application is not a pertinit until signed by the
TIDN: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED CALL Btoldin� Official or his/her Deputy.and Foes ate paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO OR INSPECTION queeipt is acknowledged in space provided.
wo�JWEI`TS-CQ,MPENS�I�URANCE AND RCW 18 27.
OF LAI, SIG ArURE DATE
D�W SI D (42
SIGN�T`URE (0 ER OR �FNtlf)
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771-0220 R SFD BY /-6-ATE
A . TTENT6 EXT 1333
IT IS UNL FU To USE OR OCCUPY A BUILDING OR STRUCTURE UN IL
A FINAL NSPECT ION HAS BEEN MADE AND APPROVAL OR A CERTI - ORIGINAL -FILE - YELLOW�INVIECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 13INK - OWNER - GOLD ASSESSOR
09/03 PRESS HARD -YOU AR NG 4 COPIES
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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 INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
The initials wr are miitoi,
Thompson, a temporary contract
inspector for tile City.
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