20051078.pdfDATE RECEIVED
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[PERMITEXPIRES
PERMIT
CITY OF EDMONDS NUMBER 62�.15 AD' 7 F
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APTV
ADDRESS
OWNER NAME/NAME OF qUSINESS avc_
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M IING ADDRESS
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approvea
RW Permit Required
CITY ZIP TELEPHONE,/,f EXISTING PROPOSED Street Use Perrrd Requited
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STATE LICENSE NUMBER EXPIRATION DATE
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NUMBER _jNUMI1E
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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
Grading
SEPARATE PERMISSION.
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
V) U 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit
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.j IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
x Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Potal Amt. Due
31DEEMED
: NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Be Receipt # 5
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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 APPLICATION API 3ROVA I
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This ripplication is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Foes are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged IF) space Provided
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
OFFICIALS SIGNAT 'RE
S1 NATURE 10 !R ORIQ �EN DATE SIGNED (425) DATE
771-0220 'RELEASE Y DATE
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. 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
......................
FOUNDATION:
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Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wall ........
Slab Insulation ..........
PLUMBING:
Underground ...... I .......
Rough -in ....................
Commercial Final ......
HEATING:
Gas Test ....................
'Gas
Piping ..................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING.........................
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ....................
Floor Insulation .........
Wall Insulation ...........
Ceillng Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
C�6
OCCUPANCY .................
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