20070366.pdf04TE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
ER NAMEVIAME OF BUSINESS
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REMARKS 1
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VALUATION I FEE
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PLAN CHECK NO: JVEITEO DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK To
BE DONE ON PRIVATE PROPER Y ONLY. ANY CONSTRUCTION ON,THE PUBLIC
GRADINGIFILL
2 DOMAIN (CURBS, SIDEWALKS, DRIVE
n SEPARATEWAYS , MARQUEES, ETC,� W LL REQUIRE
PERMISSION.
,;.ffsuRcHARGEd�jj
PE MIT APPLICATION: 180 DAYS
I), PERMIT LiMIT.'l YEAR - PROVIDED WORK IS STARTED WITHIN 18D DAYS
ENG REVIEW FEES
SEE BACK OF INK PERMIT FOR MORE INFORMATION
PPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
w IN NTEAEST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAP No
2 EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
A "'RE TLYORINDIRECTLY
LL CIL IMS FOR DAMAGES Or WHATEVER NATURE, ARISING
INSPECTION FEE
RECEIPT
m FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF FHtS ALL NO I BE
PERMIT SH ORDINANCE
0 T=FYWAIVEOR REDUCIANYIEQUIRIMENTOFANY CITY
PLAN HECK Or' SIT
c
N=T WAY THE Cl TWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
RECEIPT
TOTAL AMOUNT DUE
(HERE Y 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
T EQWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
Thl, IPPI11111-1 bll I pa -lb 11 11pld by III
TMN ' AND IN DOING THE WORK ACT HORiZEO THEREBY. NO PERSON WILL BE EMP OYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WAS14INGTON RELATING To
G"I Olh-I b, D,puty: Ild F111 11, PlId. b�'l
FOR INSPECTION 111.pt �l Ilk-tedood In 1plo P-IdId,
WORK.EN'S COMPENSATIOlobleMANCE AND RCW 1 B.27,
OFFICIALS SIGNATURE
SIGNATUR DATE 111NIO
(425)
LL11 �_l
1 771-0220
IxIe-fl-
RELEASED BY
ATTENTION J V
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL � FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: ( — -----
---FIRE DEPARTMENT DATE_L 3-177
ENGINEERING DIVISION DATE-
--PLANNING DIVISION DATE—
PROJEC
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sn'EADDRESS� C2_-7 IL-APL(C
PERMIT #
�Q�O�ADB# DATE INSPECTED—,S_
DESCRIPTION OF WORK TO BE INSPECTED /f 6147z� tee
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 BONDS and the granting of
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
o Copy of CONDITIONS given to owner/contractor by inspector
I
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sim
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ...................
wait ...............
Pier/Porch .................
Retaining Wall
Stab Insulation ..........
PLUMBING:
Underground .............
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Rough -In ..... ............. .
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'Final
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Commercial
HEATING,
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Gas Test ....................
Gas Piping .................
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Equipment ��.: ...........
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Commercial Final
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EXTERIOR SHEATHING
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NAILING ..........................
FRAMING ........................
ITIO
FIRST FLOOR FRAMING
INSULATION ..............
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL F013
OCCUPANCY ..........
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