20050744.pdfDATE RECEIVED
[PERMIT EXPIRES
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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Description FEE Description FEE
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Plan Check SlateSurcharge
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HEAT�SOURCE LOTSUOPE% VESTED DATE
Building Permit 11571 City Surcharge
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PLAN CHECK NO:
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Plumbing Base Fee
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1"I PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
Mechanical
BE DONE ON 1.1VATE PROPERTY ONLY. ANY .... T ... THIN .. THE P UStC
Grading
'ONMAIN (CUREe5, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: SEE ECDC 1940.005(A)l5i
Engr. Review
PERMIT LIMIM SEE ECDC 19.00.005(A)(6l
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
IPPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESSORS
Fire Review Plan Chk Deposit
W IN INTEREST. AGREES TO INDE NIFY, DEFEND AND HOLD HARMLESS THE CITY OF
S TS FFICtALS, EMPLOYEES, AND AGENTS FROM ANY AND
EDMOND , WASHINGTON, 1 0
Fire Inspection Receipt #
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR IN"RECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
OR RED ICE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapeinsp. Total Amt. Due
DEEMED TO MODIFY, WAIVE
NOR LIMIT IN ANY WAY TH CITY's ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee Recoipt #
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND T14AT I AM THE OWNER, OR THE DULY AUTHORIZEO AGENT OF
Th,� 'P' u" bl.hI
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THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC�
NO PERSON WILL BE EMPLOYED
CALL pDd Pd
TION: AND IN DOING THE WORK AUTHORIZED THEREBY.
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION 11111pI 11 111,11-dpd �, I�W P111d1d
WORKMEN'S COMPENSATJ�ffll AND How 18:27.
E DATE
WIGY
(425) , 11,
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771-0220 'DATE
REfEASED By
1
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 - YELLO." iNS'Ed(TOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 I IRC110. PINK OWNER - GOLD - ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ..............
FOUNDATION:
Footing .............
wall..........................
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Pier/Porch .................
9
Retaining Wall ...........
0
Stab Insulation ..........
PLUMBING:
0 :C
Underground .............
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0
Rough -in ...................
0
Commercial Final
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HEATING:
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Gas Test .............
Gas Piping .............
0
Equipment ............
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Commercial Final
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EXTERIOR SHEATHING
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NAILING .......................
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FRAMING ........................
171 0
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FIRST FLOOR FRAMING
7-f
INSULATION .............
Floor Insulation
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Wall Insulation ...........
3:
Calling Insulation
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0
SHEETROCK NAILING
0
171
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................