20051042.pdfDATE RECEIVE4
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112aX Description
Plan Check
HEATSOURCE LOTSLOPE% VESTED DATE
Building Permit
PLAN CHECK NO:
L!U`71 Plumbing
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUC71ON ON THE PUBIC
DONMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
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2 Engr. Review
0: PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
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13. PERMIT LIMIT. SEE ECDC 19.00.005(A)(6) Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review
(f) '51
U.1 IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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 Landscapelnsp.
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
9 Recording Fee
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- CALL
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 FOR INSPECTION
WORKMEN'S COM PENSATIOh0lipp RANCE AND RCW 18:27.
SIGNATU R DATE S (425)
771-0220
FEE Description
State Surcharge
,City Surcharge
Base Fee
FEE
Plan Chk. Deposit
Receipt #
Total Amt. Due
Receipt # I
APPLICATION APPRovAL
This application is not a permit until signed by [he
Building Official or his/her Deputy: and Foes are paid, and
r9geipt is acknowledged in space provided.
AT U DATE
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.EASED BY , ) I I DAT E
ATT NTION EX L 1;5;5;5 4t " / , /. �)41 ) / i
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL E&Z,21z, /,//?
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- �R'IGINAL -FILE - YEI I OW / INSF14TC
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 I IRC110. PINK -OWNER - GOLD ASSESSOR
110104 PRESS HARD - YOU ARE MAKING 4 COPIES
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F1.NA_ PROJECT APPROVAL FAIM
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
DEPARTMENT DATE
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ENGINEERING DIVISION DATE
PIXASH SIGN
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A field inspection was conducted to determine compliance with -approved plan&. Final approval
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denotes that there are no objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of:,
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GRANT FINAL PROJECT APPROVAL.
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GRANT PROJECT APPROVAL WITH QONDITIONS NOTED-
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FAILED FINAL INSPECTION OUTSTANDING ISSUES
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Copy of CORRECTION NOTICE given.to owner/contrac tor by inpector
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RE-ENSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECTAPPROVAL
Date Signature
1:temp:b1dg:fonns:ocaprv1 3/25/04