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CONSTRUCTION PERMIT APPLICATION Joa REV SUITE/APT#
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OWNER NAMEINAME OF BUSINESS
PLAT NAME,iSUBDIVISION NO. LOT NO. LID NO
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REQUIRED DEDICATION FT Unaurgtwnd L3
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NAME METERSIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
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Description
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Plan Check
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VESTED DATE
Building Permit
PLAN CHECK NO:
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAtN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
OCCUPANT
LOAD
Description
State.Surcharge
City Surcharge
Base Fee
FEE
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A S Fire Review Plan Chk. Deposit
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSOR
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Receipt #
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, 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 Landscapeinsp. Total Amt. Due
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL 4 ,
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application is not a porfrut until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building Official at hisihor Deputy: and Fees are paid, and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED receipt is acknowledged in space provided.
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
WORKMEN'S COMPEN�� DA E
�RANCE AND RCW 18:27.
7NE R 416ENT): DATE S19NED
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771-0220 DA+'
ATTENTION EXT. 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL FILE YELLOW - INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC1109 / IBC110 I IRC110. PINK -OWNER GOLD - ASSESSOR
10104 PRESS HARD YOU ARE MAKING 4 COPIES
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MEMO TO: PE 00 0 BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE__�,
ENGINEERING DIVISION DATE
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A fleld inspection was conducted to determine final compliance with ap roved plans. Final approval
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denotes that there . are no objections, from. the above signed Department to the release of
PERFORMANCE BONDS and the granting of
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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FAILED FINAL INSPECTION OUTSTANDING ISSUES:
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign,
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Pier/Porch , ...............
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Retaining Wall ...........
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Slab Insulation ..........
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PLUMBING:
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HEATING:
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Gas Test .....................
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Equipment .................
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EXTERIOR SHEATHING
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FRAMING ........................
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FIRST FLOOR FRAMING...
INSULATION ....................
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Floor Insulation .........
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Wall Insulation ...........
Ceiling Insulation ........
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SHEETROCK NAILING ...
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SPECIAL INSPECTION
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