20060197.pdfDATE RECEIVED PERMIT EXPIRES
PERMIT
CITY OF EDMONDS NUMBER
CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPTO
ADDRESS
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Description
FEE Description FEE
Atfi Alva) W�L
Plan Check
State Surcharge
HrATSOURCE PT SLOPE% VEU DATE
Building Permit
City Surcharge
PLAN CHECK NO:
Plumbing
Base Fee
3
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
BE DONE ON PRIVAT PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
Giadmg
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
PERMISSION.
SEPARATE
PERMIT APPLICATION: SEE ECDC 19.00,005(A)IS)
Engr Review
PER H
MIT L MIT., SEE ECDC 19.00.005(A)Ht
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection
-APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEF No AND HOLD HARMLESS THE CITY OF
a EDMONDS , WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt #
FROM THE I SUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMEDTO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
14OR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Landscape Insp.
Total Amt. Due
Recording Fee
Receipt #
lHERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT TH INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
Th., ppit-b- - , pthe,t nt.1 119hed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
EMPLOYED
CALL
Offi-I Ie R-er Deree, hel Fwe - bed. ed
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION �R petd
WORKMEN'S COMPENSATItNCIE AND RCW 18:27.
DER I SSIGNATIURE D+E
OATE SIGNED
(425)
7RELE�SED
j771-0220
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-
ORI -FILE -.YELL W -INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC1091 IBC110 / IRC110.
PGINML
INK -OWNER GOLD - ASSESSOR
10104 PRESS HARD - YOU ARE MAKING
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Permit Inspection Details
Permit: BLD20060197
PERMITTRAX
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08/1112006 MS 20 CORRECTION NOTICE WRI77EN
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08/2212006 MS 20 FINALAPPROVED
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Total Time: 40
Total Inspections: 2
Total Time: 40
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