20050561.pdfDATE RECEIVED
I PERMIT
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inspection Rewied
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ADDITION COMMERCIAL COMPLIANCE OR 0
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Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE
LOT SLOPE%
VESTED DATE
Building Permit
6)0
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
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Grading
Engr. Review
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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
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OAPPLICANT,.ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSICNS AND SUCCESSORS
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 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
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Fire Review
Plan Chk- Deposit
Fire Inspection
Receipt #
Landscapeinsp.
Total Amt. Due
Recording Fee
Receipt #
I 'WIN
1 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
CALL
FOR INSPECTION
APPLICATION APD�R
This application is not a permit until signed by the
Building Official or tits/tier Deputy: and Foes ate paid, and
1\ roceipt is acknowledi . ��Race provided
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
(425)
.771-0220
I LIS SIGNA JJE
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DATE
SIGNATUQE (OWNER OR AG
DATE SIGNED
or
RELEASEA B
DATE
ATTENTION EXT. 1333
IT IS UNLAWFUL TO USE 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. UBC109 / IBC110 / IRC110. PINK - OWNER GOLD - ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATIOW,
Footing .......................
Wall...........................
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Pier/Porch .................
Retaining Wall ...........
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Slab Insulation ..........
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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 .... ...............
2:
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Equipment .................
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Commercial Final ........
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EXTERIOR SHEATHING
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NAILING ............................
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FRAMING ........................
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FIRST FLOOR FRAMING ...
INSULATION ....................
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Floor Insulation .........
Wall Insulation ............
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Coiling Insulation ........
SHEETROCK NAILING ...
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SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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