20060511.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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D Description
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FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE LOTSLOPE% VESTED DATE
4COVEASWORK
-LRId In. Parmin
pGrading
City Surcharge
PLAN CHECK NO:
Plurnbing
Base Fee
Mechanical
THIS PERM T AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT 0. TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUSIC
B TC, WILL PEOU
DONMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION,
Engr. ReVi—
PERMIT APPLICATIOW SEE ECDC 19.00.005W(5)
Engr, Inspection
PERMIT LIMIT. SEE ECDC 19,00,005(A)(6)
SEEBACKOF INK PERMIT FOR MORE INFORMA ION
'APPLICAIYT� ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
Fire Review
Plan Chk. Deposit
IN NTEREST, AGREES T INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Receipt at
E EOM NOS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTLSYFOR�OM ANYCATNLD
0 No RE Y
ALL CLAIMS F R DAMAGES OF WHATEVER NATURE, ARISING DIRECT
Fire inspection
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
CITY ORDINANCE
Landscapeinsp
Total Arnt Due
DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY
NOR LIMIT IN ANY WAY THE CITY'$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
Recording Fee
Receipt
EREBy ACKNOW EDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
VEN'S pgaee.r� Ea . T B DULY AUTHORIZED AGENT OF
,ANg'NAT'A.qNEgN , B B
TPj,I plF.,. P., . p. — -,I �Xin.d by
HE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING
JJI�IoN;
CALL
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AND IN BIN THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
G RELATING To
THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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]CONSTnUC�
N VIOLATION OF THE LABOR CODE OF
WORKMEN'S COMPENSAT=NCE AND RCW 1817.
OFFICILS
kSIGNATURE(O NEROR(!:!:�) DATE GNED
(425)
7S1,1A11R1
771-0220 FEIEAMD BY tDATE
AffVifION
EXT. 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 0 STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
ORIGINAL -FILE - YELLO -INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBCiO9 / IBC110 I IRC110.
PINK -OWNER . GOLD -ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATE__k__(�___<) (I
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE
'PROJECT
SITE ADDRESS- q"L 2- 0 2- Z-
PERMIT # #_____---PATE INSPECTED ?
DESCRIPTION OF WORK TO BE INSPECTED U3211 C
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BOkMS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date_ Sign_
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Permit Inspection Details
Permit: BLD20060511
PERM
6M 4
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0610812GO6 S�rrial 35 APPROVal)
Total Time: 35
Total Inspections:
Total Time: 36
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
............
Pler/Porch .................
Retaining Wall ..........
Slab Insulation
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
Gas Test .,_ ................
Gas Piping .................
Eq I
ulpinent', .............
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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