20050557.pdfDATE RECEIVED
PERMIT EXPIRE 611 U �L.
CITY
OF EDMONDS
PERMIT
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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Description
FEE
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Plan Check
HtAT SOURCE LOT SLOPET—
VESTED DATE
Building Permit
0
PLAN CHECK NO: C) asl�—
Plumbing
Mechanical
THIS PERMIT 7THORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Grading
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERM ISSION.
Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
6;0,
PERMIT LIMIT: SEE ECDC 19.00�005(A)(6)
SEE BACK OF PINK'PERMIT FOR MORE INFORMATION
Engr. Inspection
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HE!RS, ASSIGNS AND SUCCESSOR S
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
:E EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVEFt NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Review
Fire Inspection
Landscapelnsp.
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
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
Recording Fee
CALL
FOR INSPECTION
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 COMPENSA719!!:!4,URANCE AND RCW 18:27.
(425)
771-0220
EXT. 1333
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DATE SIGNED
17
16; 6'5
1
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC110.
10104 PRESS HARD - YOU ARE MAKING 4 COPI
OCCUPANT
LOAD
Description_
State Surcharge
City Surcharge
Base Fee
FEE
Plan Chk. Deposit
Receipt #
Total Amt. Due
Receipt # ------ —
APPLICATION APPROVAL
This application is not a permit until signed by the
Building Official or his/her Deputy- and Fees are paid. and
receipt is acknowAdged in space provided
lil- - FILEX - IYELLOW - INSPECTOR
- OWNEAJ GOLD - ASSESSOR
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iF INAL PROJECT APPROVALFORM
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
.SETBACKS .....................
FOUNDATION:
Footing . ......... .............
Wall...........................
Pier/Porch .................
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0
Retaining Wall . ...........
0
Slab Insulation ..........
PLUMBING:
C/5
Underground .............
1711
C
M
Rough -in ...................
0.
0
0
Commercial Final ......
HEATING:
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GasTest ....................
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-Gas Piping ..................
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Equipment .................
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Commercial Final .......
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EXTERIOR SHEATHING
0 W
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NAILING ..........................
0 M
C Cn
FRAMING ........................
ITI 0
FIRST FLOOR FRAMING...
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INSULATION . ...................
;0
Floor Insulation .........
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Wall Insulation ...........
Ceiling Insulation ......
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SHEETROCK NAILING ...
0
SPECIAL INSPECTION ...
1711�
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .......... .......
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