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ADD NO.
Legal Description of Property Include all easements
SHORELINEM
DATE
SETBACKS — FEET
HEIGHT LOT
COVERAGE i
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REMARKS
111 1' RESIDENTIAL O PLUMBING
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ES
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PROGRESS INSPECTIONS PER UBC 305
ITY PE OP (USE. BUSINESS OR rtvlrn EKPLAIN:
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DESC BE WORK TO BE DONE (ATTACH PLOT PLAN)
FINAL INSPECTION REOUIRED
VALUATION
FEE
PLAN CHECK FEE
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Plan Check No.
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MECHANICAL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
drtveways, marquees, etc.) will require separate permission.
GRADINGIFILL
STATE SURCHARGE
Permit Application: 180 Days
STORM DRAINAGE FEE
Permlt Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant. on behalf of his or her Spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
w harmless Ine City of Edmonds, Washington, its officials, a employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the Issuance
x of this permit. Issuance of this permit shall not be deemed to
omodify, waive or reduce any requirement of any city ordinance
x nor limit in any way the City's ability to enforce any ordinance
provision."
ENG. INSPECTION FEE
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j�� ✓�
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PLAN CHECK DEPOSIT
TOTAL AMOUNT DUEc^"�'i
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I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and THIS PERMIT
state laws regulating construction; and in doing the work authoriz- AUTHORIZES This application is not a permit until
ad t;q Bby, no person will be employed In violation of the Labor ONLY THE signed by the Building Official or his/her
Co.el the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
Ito Insurance and RCW 18.27. INSPECTION acknowledged in space provided.
SIG /TURE OWNER ORGE T11 DATE 11 j DEPARTMENT
/�,� , Iwo I) �' ( c �+ CITY OF O I NATURE D TE
VV l( N `h\/ LL EDMONDS
CALL FOR ELEAS ,� DATE
ATTENTIO
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector 771 �oL`O
A OFnTIF1('ATF. OF OCCUPANCY HAS BF.FN GRANTED, UBC
^NApTFR .l
CITY OF EDMONDS ZONE PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION f..'+
JOB
OWNFT NAMI_ NAME OF nUSINESS ADDRESS _ �� . UITE APT n
LEGAL DESCRIPTION CHECK SUDDIVISIOfJ HO LID NO
MAR INC, AR()RESS
(.II ZIP , TELEPHONE NUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AP 11111d ❑
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EXISTING __._ REOUIRED DEDICATION RW Ppf mil Rw(uund ❑
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RECORD OF INSPECTIONS
INSPECTOR DATE APPRO'
SETBACKS ...................
FOUNDATION:
Footing ....................
Wall .......................
Pier/Porch .:..............
Retaining Wail............
Slab Insulation ............
PLUMBING:
Underground .............
Rough -In .................
Commercial Final ........
HEATING:
Gas Test .................
Gas Piping ................
Equipment ................
Commercial Final.........
EXTERIOR SHEATHING
NAILING ....................
FRAMING .............:......
INSULATION:
Floor Insulation ..........
Wall Insulation ...........
Ceiling Insulation.........
SHEETROCK NAILING ......
SPECIAL INSPECTION ......
RADON MONITOR AT SITE.
FINAL APPROVAL
FOR OCCUPANCY......
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