20050177 (2).pdfI
DATE RECEIVED
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CITY OF EDMONDS NUMBER
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Sidewaik Required [3
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NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
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GARAGE o RETAINING WALL FIRE SPRINKLER
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DESCRIBE WORK TO BE DONE REMARKS
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Description FEE Description FEE
Plan Check State Surcharge
HEAT URCE LOT SLOPE% VESTED DATE Building Permit City Surcharge
["PLAN CHECK NO: Plumbing Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC Grading
DONMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
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SEPARATE PERMISSION. Engr. Review
cr PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
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PERMIT LIMIT: SEE ECDC 19.00.005(A)(6) Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit
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
x ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM HE ISSUANCE OF THIS PERMIT. ISSUANCE or THIS PERMIT SHALL NOT BE
Landscapelnsp. Total Amt. Due
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
1: Recording -Fee, Receipt # I
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 This application is not a permit until signed by the
,THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. CALL Building Official or his1her Deputy and Feesare paid. and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED/ receipt is acknowledged in space Provided
TON RELATING TO FOR INSPECTION
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHING
WORKMEN'S COMPENSAT?011� 18:27.
TRANCE AN , D RCW OFFICIALS SIGNATURE DATE
DATE S GNED (425)
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SIGNATU�R,f�
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177 771 f7x/
._.,_EXT. 1333�
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE U14TIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL - FILE YELLOW - INS6EC R
-OWNER - GOLD 9R'
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC1091 IBG110 / IRC1110. PINK - ASSESS R
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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 ..........................
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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