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PERMIT EXPIRES � 2 2�
CITY OF EDMONDS
0S1 PERMIT
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„ � NUMBER 980797
CONSTRUCTION PERMIT APPLICATION
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❑ ADDtTION ❑ COMMERCIgL ❑ CHANGE OF USE
❑ REMODEL ❑ APARTMENT ❑ SIGN
❑ REPAIR ❑ GRADING CVOS FENCE
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ITYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
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PROGRESS INSPECTIONS PER UBC 108 c
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NUM1IBER
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STORIES
NUMBER OF
DWELLING
UNITS
CRITICAL
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NUMBER
Y
UESC•HIG WORN TO BE GONE
FINAL INSPECTION REQUIRED
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE
GLAZING °°
1OT SLOPE °'°
BUILDING
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PLAN CHECK NO:
VESTED DATE
PLUMBING
MECHANICAL
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS.SIDEWALKS. DRIVEWAYS. MAROUEES,ETC.I WILL REQUIRE
GRADINGIFILL
SEPARATE PERMISSION.
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STATE SURCHARGE
PERMIT APPLICATION: 150 DAYS
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
STORM DRAINAGE FEES
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS ENG. INSPECTION FEE
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
c EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYE ES. AND AGENTS FROM ANY AND �I� -(� �
t ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE.ARISING DIRECTLYOR INDIRECTLY - t
p FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN 15 CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
T HE OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUE CALL Thls appkcanoP rs aol a parmd unhl sl0nod by the
DON. AND INDOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED BVIldmO O0¢Ial or hrslhar Dapoly and Foos are pard. and
IN VIOL TION OF THE. LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
'tlOFt N'ti COMPENSATIO INSURANCE AND RCW 1627 r.-P l Acknowlodppdmspa pr—d.d
�I ,N IRE OOWNER OR NT; DATE SIGNED (425) OF 1 SIG E DATE
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All— 771-0220
E NTIO N RELEASED BY AT
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1 IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- . I:rIGW INSPECIOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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'-Everett, WA 98201
(425)252-2373
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
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Walt ..........................
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• ��'y
Pier/Porch .................
Retaining Wall ...........
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 ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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OCCUPANCY ..................
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