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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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FEE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION,
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Jul PERMIT APPLICATION: 180DAYS
CL PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG�RLV1EZLLLF_S
Fee
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
V) 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
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ENG. INSPECTION FEE
UJI IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAPING
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EDMONDS, WASHINGTON. I rS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
INSPECTION FEE
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
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RECEIPT
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
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DEEMEDTO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OFANY CITY ORDINANCE
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NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANYORDINANCE PROVISION.-
RECEIl
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APP�ICATION 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
1 his appli ation is not a pennil tintil signed by the
'I
TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Official or his/her DOPLAY:and Foosaro 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 INS ANCEANDRCWI82�
OFFIC
DATI
SIGNATURE (OWNEP O�A��N
ATE
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57 10
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771-0220
DATJ
RELEASED11i
A17ENTION
EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SE.CTION 109
FAX
PINK -OWNER - GOLD - ASSESSOR
5/98
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall....... ..................
Pier/Porch .................
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Retaining Wall ...........
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Slab Insulation ..........
PLUMBING:
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Underground .............
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Rough -in .....................
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Commercial Final ......
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HEATING:
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Gas Test ....................
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Gas.Piping ..................
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'Equipment ..................
Commercial Final .......
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EXTERIOR SH EATHING
NAILING ..........................
0 M
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�-�FOIAMING ......................
IT! 0
FIR�T FLOOR FRAMING....
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INSULATION' .................
Floor* Insulation ......... .
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Wall Insulation ...........
Ceiling Ins ulatlon .......
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SHEETROCK NAILING ...
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SPECIAL INSPECTION ...
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MISCELLANEOUS ..........
FIN AL APPR OVAL FOR
OCCUPANCY .................
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