20060179.pdfGab� DATE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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THSPERMITA HORVES ONLY THE WORK NOTED. THISPERMIT GOVE S WORK TO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCT ON ON THE PUBLIC
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S DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: SEE ECDC 19.00,005(A)(5)
Engr. Review
Recording Fee
PERMIT LIMIT. SEE ECDC 19.00.005(A)(6)
ng. in spection
Plan Chk. Deposit
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
;APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
N INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CIT or
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
x FS M THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL N,OT BE
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DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY P SO NANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE ROVISION.'
Fire Review
rLandscape
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Receipt #
Fire Inspection
Total Amt. Due
Insp..
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. A D THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC'
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL HE EMPLOYED
IN VI LATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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WORKMEN'S COMPENSATION INSURANCE AND RCW 18;27�
CALL
FOR INSPECTION
(425)
APPLICATION APPROVAL
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EXT. 1333
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITI-
OF OCCUPANCY HAS BEEN GRANTED, UBC1091 IBC110 I IRC`110�
ORIGINAL FILE YELLOW INSPECTOR
PINK -OWNER GOLD - ASSESSOR
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FINAL PROJECT APPROVAL FORM
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DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATEsC
—ENGINEERING DIVISION DATE
PLANNING DIVISION DATE—
PROJECT__f,D_49A4,e�C�kAC,C
SITE ADDRESS 44f�:40 /. :� r, 't J Y-6 9
PERMIT ADB#_DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED Alz;,g),�2
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 and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:tcnip;b1dg;fornis:ocaprv1 3/25/04
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fbrms:ccaprv1 3/25104
Permit Inspection Details
Permit: BLD20060179
PE:RMITTR,�x
05/0412006 BMlT'H 30 APPROVED
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Total Time: 30
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05/12/2006 BULLOCK 30 APPROVED
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Total Time: 30
Total Inspections: 2 Total Time: 60
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6/23/2009 8:07:28 AM
Page I of I
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .................
i:OUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
GasTest _ .............
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING
FRAMING ..............
FIRST FLOOR FRAMING...
INSULATION ...............
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY
..................
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