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P ERMIT EXPIRES
CITY OF EDMONDS
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REMARKS
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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FIRE SPRINKLER
REMARKS
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GEOTECH REPORT
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Description
FEE
Description
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Plan Check
State Surcharge
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VESTED DATE
Building Permit
City Surcharge
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PLAN CHECK NO:
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Plumbing
Base Fee
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. /HIS PERMIT COVERS WORK TO
Mechanical
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
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PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
Engr. Review
Recording Fee
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PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
Plan Chk. Deposit
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
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IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Fire Review
Receipt #
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EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
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Fire Inspection
Total Amt. Due
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM TH ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
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Receipt
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
CALL
This application is not a permit until signed by the
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
FOR INSPECTION Building Official or his/her Deputy, and Feesare paid. and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
receipt is acknowledged in space provided
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
OFFICIA SSIG AJURE DATE
SIG AT E GE DATE SIGNED
(425)
771-0220
RECKA BYA AATE
EXT. 1333
TENTI
IT IS UNLAW TO USE OR PY A BUILDING OR STRUCTURE UNTIL
dEN
A FINAL INSPECTION HAS MADE AND APPROVAL OR A CERTI-
ORIGINAL - FILE YELLOW INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC110.
PINK -OWNER GOLD - ASSESSOR
6/05 PRESS HARD YOU ARE
MAKING 4
COPIES
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FINAL PROJECT APPROVAL FORM
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DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT D ATE
PLFXSE SIGN
ENGINEERING DIVISION DATE
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PLANNING DIVISION DATE
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DESCRIPTION OF WORK TO BE INSPECTED. I
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A field inspection was conducted to determine compliance with approved plans. Final approval
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denotes that there are no objections from the above signed Department to the re lease of
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PERFORMANCE BONDS and the granting.o'f
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
El Copy of CORRECTION NOTICE given to owner/contractor by inpector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fbrms:ocaprv1 3/25/04.
RECORD OF INSPECTIONS
INSPECTOR DATE APPR OVED
SETBACKS ............ ........
FOUNDATION:
Footing .... ..................
Wall ...... ....................
Pier/Porch .................
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Retaining Wall ...........
slab Insulation ..........
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PLUMBING:
Underground .............
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Rough -In ...................
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Commercial Final ......
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HEATING:
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Gas Test .....................
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Gas Piping .................
Equipment ..................
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Commercial Final .......
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EXT ERIOR SHEATHING
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NAILING...........................
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FRAMING ........................
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FIRST FLOOR FRAMING ...
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INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
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Ceiling Insulation .......
SHEETROCK NAILING ...
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SPECIAL INSPECTION ...
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .................
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