20040872.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
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PLAT NAME/SUBDIVISION NO. LID NO.
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TESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required
Street Use Permit RGQ'd 13
EXISTING — PROPOSED inspection Required [3
sidewalk Required [3
Underground
REQUIRED DEDICATION� FT wiring required
METER SIZE LINE SIZE NO. OF FIXTURES PRV REOUIREID
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 8
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SEPA REVIEW
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ALLOWED PROPOSED
DATE
DATE
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SPROGRESS INSPECTIONS PER UBC 108/IBC1091IRC109 FINAL INSPE,CTION REO'D
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ILMICHECK NO: VESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESOBS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NAT URE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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
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-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S QQMQENSATION INSURANCE AND RCW IB.27.
VALUATION
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Description FEE Description FEE
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Plan Check 10
Building Permit City Surcharge
Plumbing Base Fee
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Fire Inspection Receipt #
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APPLICATION APPR
This application is not a Permit until signed by the
CALL Building 011icial or his/her Deputy. and Fees are paid, and
FOR INSPECTION rLcLipi is acknowledged in space provided,
r_ OFFICIALS SIGNATURE , DATE
S I G NAT U f%;`W N E,10TO R EN DATE SIGNED
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'771-0220 try.
RISL E A00 BY 11
ATTENTION EXT 11333
IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVALOR A CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/lBC110/IRC110.
09!03 PRESS HARD -YOU ARE MAKING 4 COF IES
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CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS. WA 98020 - (425) 771-0220 - FAX (425) 771-0221
Websile: mvwxi.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
C. 1 sc)�) Planning - Building * Engineering
December 3, 2004
Attn: Kirsten Johnson
PO Box 684
Edmonds, WA 98020
Building Permit: 2004-0872
Site Address: 9405 218th PI SW
Expiration Date: 4/18/05
Dear Kirsten Johnson:
GARY HAAKENSON
MAYOR
The purpose of this letter is to infOrm You that the last remaining inspection on your
project is a final inspection(s). Tile Final inspection(s) determines that there are no
outstanding life -safety issues and approval allows the City to close your pern-lit file.
The City considers the final inspection to be one of the most important inspections
conducted oil a project. In order to grant final approval the following must be complete:
smoke detectors, house numbers, guardrails, handrails, self -close doors between garage
and residence, egress from sleeping rooms, safety glazing, weather-stripping, any
Engineering department requirements etc. Of course not all of these things may
specifically apply to your project but it does give you an idea about the kinds of things
that Must be complete as well as sonic items that do not need to be installed such as:
paint, carpet, moldings, wallpaper, etc. Please be advised perrilits expire one year from
the date of issuance. if you will need more time to complete tile work, permits can be
renewedprior to expiration for one half fees. If the permit expires without a final
approval granted by the Building Inspector, full fees are required in order to renew tile
permit. This can be very costly to You and we strongly encourage you to check your
permit expiration date and call for the required final inspection(s). Note: If more than
one department is required to final your project, this is noted oil Your Job Card.
Please feel free to contact me at 425-771-0220 if you have any questions.
Sincerely,
Permit Coordinator
Incorporated August 11, 1890
Sister City - Hekinan, Japan
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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:
GasTest ....................
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
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FRAMING........................
FIRST FLOOR FRAMING ...
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INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL, FOR
OCCUPANCY ..................
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