20000177.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION F-0-N,
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PERMIT
NUMBER
PUBLIC RIGHT OF WAY PER OFFICIAL STREET -AP I
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T�)STIP.
PROPOSED
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ER
LINE SIZE
NO, OF FIXTURES
FAV REQUIRED
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I YES 0 NO 0
EXP
LOT COVERA- FRONT $10 ....
ALLOWED I PROPOSED I FEAR' FRONT U
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1.1cel NO. ?y
LOT AREA
Y
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LlRESIDENTIAL
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ADDITION
....BCIAL
COMPLIANCEOR
CHANGEOFUSE
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APT. BLDG.
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RE.ODEL
GRADING
FENCE
PECKED BY ITYPE
OP CON.T ... I — CODE
CP
ORO,
10 C,
REPAIR
CYOS
X_
_x—FT)
I x
S6W
ElDEMOLISH
WINSSEORDT"To"'
E] S. . POOL
HOTTUBISPA
SPECIAL INSPECTOR AREA
REQUIRED 0 YES
occu
LOAD
G PAGE
RETAINING WALL/
RENEWAL
EMARKS
CA
ARPORT
ROCKERY
PROGRESS INSPECTIONS PER USIC 108
TYPE OF USE, BUSINESS 0 ACTIVI LAIN:
NU BER NUM11 0
OF Ry��LLING
- I T
4
FINAL INSPECTION REOUIRED I I
IN I FEE
PLAN CHECK FEE
HEAT SOURCE: G!
,
—
Plan Check No.
MECHANICAL
-This -Permit covers work to be done on private property ONLY.
GRADINGIFILL
A y I
n,=t=,o,n, the,)public domain sidow?lks,
dD etc will require Be= permission.
STATE SURCHARGE
Pe It Application: 180 Days
EE
Permit Limit: I Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns anldd
interest, Indemnify, de fend and ho
ENG, NSPECTION FEE
a uccessors in agrees dto
ar I
IT Dress the City of Edmon a We h ton, its officia 5,
'g.h. from any �nd alsl.�Ggims for damages of
elssuanc
empllo':Bsn�.anrd d a
whatev 1. a, irsing directly or Indirectly from th
Issuance this shall not be earned to
PLAN CHECK DEPOSIT
of this permit, of Permit
mod ity' waive or reduce any requirement o� any city ordinance
nor limit In any way the City's ability to an orce any ordinance
TOTAL AMOUNT DUE
provision."
dge that I have read this appli I on; ' thy
cat tha a
ATTrNT)ON
APPLICATION APPROVAL
information given is correct; and that I am the owner or the dul
authorized agent of the owner. I agree to comply with city and
S PER."
This application is not a permit until
state laws regulating construction: and In doing the work authoriz-
-T.-ZES
oNL TIE
I
ildin Official or his/her
Big ad b 'he Bu' 1 9 0 "'
y
ed th To y, IT pe n .111 be employed In violation of the Labor
WoR Or D
C
are padr,.an E. a is
P t" and Is IT
Codeofthe DueOf ashington relating to Workmen s Compensa.
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ck Is e n. P
Pon Insurance atid .27.
�TE XIG�ED
H,FECTION
DE P
,
AGENT
o
CITY OF
T E
A,B 0
W
EDMONDS
CALL FOR
LE �ssc.y A
N
INSPECTION
c A BUILDING 08 STRUCTURE
IT UNLAWFUL TrO U.TE, 0" -C UPY OR
PNPE ON HAS BEEN MADE AND APPROVAL
71-0220
ORIGINAL F�te YELLOW - lnspe�t�,
UNTIL A FINAL UBC
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED,
I
PINK - O-Er GOLD - Assessor
SECTION 109
,0261
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ....... ...........
FOUNDATION:
Fooling, .....................
wall ........ .......
0:
Pier/Porch .................
RetainingWall ............
5,
Slabinsulation
............
PLUMBING:
m
Underground.. ..........
m
01
RoUgh-In .... .......... —
6!
0 C
CommercialFinal....
M
mz
HEATING:
z
>
GasTest.; ...............
Gasiniping ..........
On
n
Equipment ..........
2
commercial Final .........
mm
0
EXTERIOR SHEATHING
0
C 0)
N
M 0,
r—
FRAMING ....................
INSULATION:
Floor Insulatlom-.;
7��,
Wall Insulatio ...........
Cellinginsuiation .........
SHEETAOCK NAILING ......
SPECIAL INSPECTION ......
m
MISCELLANEOUS
FINAL APPROVAL
:fl =1/100
FOR OCCUPANCY...
or
"-I
USE PERMIT
CITY OF EDMONDS NUMBER 200-177
'7009" UITEIAP #
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEI.AME .1 BUSINESS ADDRESS
� ,I
LEGAL DES MOTION CHECK SUA.IIISION NO/ I'D
.AAAARd
A V—k4=-'1k
vv,l -q.ck PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP App,-4 o
Aw P.— R.q.�� d
REQUIRED DEDICATION s
EXISTING U-1 III. P.—I
PROPOSED S.....
PRI RIDDIFOD
METER SIZE LINE 111E,?
ADDRESS
jj�,17,01111TUAES I
YES D NO 0
5NIARKS
CITY
zip NUMBER
ITILEP"OlE
NAME
.A
MING MEMO DATED REVIMEO 81
ITT ZIP TELEPHON NUMBER
ME MEMO DATED I RVEYIED By
I -V EXPIRATION DATE
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bi, - SHORELINE.
ga escri io o party'. include all eas., -NA HEIGHT
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s VI ED
PLI. r�EMlr— LL. ALLOWED
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Exp
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OTC v REQUIRED SMACKS (FT,) PROPOSEPSETBACKa(FL)
WED FRO 0 ED FRONT SIDE REAR FRONT UPSIDE RUA
0
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P'P'n' LOT AREA Y
T t5:n
0
0
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REMARKS
M RE-SIDENTIA'l. —E] PLUMBINGIMECH
I COMPLItNCEOR
CCMMkACIA USE
Am -
El REMODEL APT.BL6
CHECKED BY CCUPANT
FENCE
01 CONSTRUCTION Cjj
01 REPAIR cy, L—X—Fn
J�E
On
DEMOLISH F-1 WOODSTOVE E] SWIM POOL SPECIAL FN—SpECTOrF- AFMA OCCUPANT
HOTTUBISPA I OAD
1
INSERT REQUIRED 1
-4
X
GARAGE f-� RETAINING WALU RENEWAL REMARKS
CARPORT ROCKERY IS
M M
PROGRESS INSPECTIONS PER USC 108
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0
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N[DIABER ---- ! — NUMBER OF CRITICAL &VA. Ag
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OF DWELLING AREAS
STORIES A-/" UNITS NUMBER
ITI 0
17,
DESCRIBE WORK TO BE DONE IATTACH PLOT PLAN�
FINAL INSPECTION REQUIRED
X
VALUATION
L I
PLAN CHECK FEE
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BUILDING
HSATSOURCE: GLAZING
Cn
MECHANICAL
Plan Check No.
0
za
ITI
This Permit cov -orkTol5e donW on private property ON LY. GRADDIGMILL
Any constructelrosn OR the public domain (curts, sidew—,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE .4
-----------
Pennit Appli oBtlon: 180 lay' 4
T1—
�, ; ",
7
If
re" By.
Permit Limit: I Year - P do Vibrik 1. St�jed
—vplIcSnt, on behalf ofnis or her spouse, heirs assigns and ENG:INSPECTION FEE
successors in Int I I d
eest, IgN;�;*-In Yf.n-.'�Ind "I
ha!rmless the City o ong 1. .11
I I c 'm or Game
employees, and agents from anyDarin C me a
whatever nature, arising direc Y , d1leNI'l I"orn In. issuance PLAN CHECK DEPOSIT
of this permit, Issuance of thlis permit hall not be deemed to
any cit ordinance
modify, w �e r reduce any raq Irement of y
I nor limit i3�1 BAD way the City's Sub Illy to an orce any ordinance TOTAL AMOUNT DUE
provision.
I hereby acknowledge the a road lhis applj�%JpriNVat, the �ATTE APPLICATION APPROVAL
" hev 6
correct I in NTI?
Information given - and that OW"
mply w,110" ie
authorized agent Of the owner, I agree to co IT of y1a"nid THIS PERMIT This application is not a permit until
is
state laws regulating Construction; and In doing the workauthorIZ. AUTHORIZES signed by the Building Official or his/her
THE
ad hereby, no person .111 a employed,in violation of the Labor WONLY
I OAK NOTED D?,p�ty: an d fees are paid. and receipt is
o St. W in 'a Componsa�
Code fine to of ash gton relating o Workmen In ledged/in space provided.
8 W-14.27. INSPECTION
flon Insurance and
KINATU ATE I I i I s NA RE
oilFOR A LEASED By DATE
-ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE On OCCUPY A BUILDING OR STRUCTURE
INSPECTION HAS BEEN MADE AND APPROVAL OR f71-0220 ORIGINAL - F.1e YELLOW - inspector
UNTIL A F;NAL
A CEATI FCATE OF OCCUPANCY HAS BEEN GRANTED. UBC
pu"
SECTION 109 GOLD - ASSeSSOf