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[PERMIT EXPIRES
PERMIT
CITY OF EDMONDS
NUMBER 6�0 —
CONSTRUCTION PERMIT APPLICATION
JOB SUITEJAPT�
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OWNER NAMSNAME OF BUSINESS
FLAT NAMOSUBDIVISION NO, LOT NO, LID 10,
MAILING ADDRESS
LID FEE S
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Description FEE Description FEE
Description
LOT SLOPEI, VESTED DATE
Plan Check State Surcharge
Plan Check
Building Permit City Surcharge
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Plumbing Base Fee
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THI PERMIT AUTHORIZES ONLY THEWORK NOTED. THIS PERMITCOVERSWORKTO
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Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION,
Grading
PERMIT APPLICATION: SEE ECDC 19�00.005JAQE)
Eng, Revew Recording Fee
PERMIT LIMIT. SEE ECDC 19.00.005(A)(6)
SEE BACK . OF PINK PERMIT FOR MORE INFORMATION
Engr, Inspection Plan Chk. Deposit
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'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
Receipt It
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
E MONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
a RaAn.W
ADLL CLAIMS FOR DAMAGES OF WHATEVER NATU E, ARIS ING DIRECTLY OR INDIRECTLY
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Fire Inspection Total A arm Due
In M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF PERMIT SHALL NOT BE
D EMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Receipt 9
0 NOR LIMIT IN ANY WAY THE CITYR ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
L andscapenale,
A PLICATION APPRO L
THERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONZ THAT THE INFER MATION
AUTHORIZED AGENT OF
CALL an
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
Ru,id,,g Oflnial 11 NIV1,01 D,puly and F,,,.i,e pda, and
FOR INSPECTION
TION; AND IN DOING T E WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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WORKMEN'SCOMPENSATIO�NINS,eANCEAN RCWU,27.
(425) SI AT RE ATE
(OWNER AD DATE SIGNED
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771-0220
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EXT. 1333
ATTENTION
ITIS UNLAWFULTO 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. UBC1091 IBC110 I IFIC110.
PINK -OWNER - GOLD - ASSESSOR
PRESS HARD - YOU ARE MAKING 4 COPIES
FINAL PROJECT APPROVXi, FORM
TO:
DATE:
MEMOTO: PERMIT, COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATE
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE
PROJECT
SITE ADDRESS.
PERMIT#J�L)�— ADB#_DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED (M //��p L4,,_3,_e �4_
A field inspection was conducted to determine compliance with -approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS ad the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
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2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:tenip:b1dg:forn1s:ocaprv1 3/25/04
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Permit Inspection Details
Permit: BLD20060081
PERMITTRAX
02/1512006 Smith 0
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Total Time: 0
Total Inspectionst
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
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Wall..........................
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PlerlPorch ...............
Retaining Wall ...........
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Stab Insulation
PLUMBING:
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Underground .............
M 0
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Rough -in ...................
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Commercial Final
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HEATING:
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Gas Test ..� .................
E:
Gas Piping .................
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Equipment .................
Commercial Final
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EXTERIOR SHEATHING
0
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NAILING � .........................
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FRAMING ........................
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FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
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Wall Insulation ...........
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Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY
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