20000315.pdfOAtE RECEIVED
PERMIT EXPIRES � L"
usE PERMIT QJ
CITY OF E®NIOND
S
ZONE !J,D NUMBER
CONSTRUCTION PERMIT APPLICATION AO rrr111 L SUITE APTx
ADDRESS � � II � � �S�\�D , L,� A
-OWNER NAMEINAME OF BUSINES
NAMEISUBDIVISION NO, LOT NO,
LID NO.
LID FEE S
w MAU 0ADDRESS
RIGHT OF WAY PER OFFICIAL STREET MAP
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ZIPS
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SIZE LINE SIZE NO. OF FIXTURES
PRV REQUIREDNAME
YES O NOADDRESS
RKSER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDPAINAGE
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ZIP'
TELEPHONE
CITY
FIRE REVIEWED BY
TELEPHONE
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DATE
J��N.IME
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VALUATION FEE
PLAN CHECK FEE
HEAT SOURCE GLAZING % LOT SLOPE %
BUILDING
PLAN CHECK NO: VESTED DATE
PLUMBING
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MECHANICAL
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THIS P ER MIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
BE GONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADINGIFILL
DOMAIN (GDA.S. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
_
SEPARATE PERMISSION.
SURCHARGE
PERMITAPPLICATION: 1800AYS
PERMIT LIMIT: I YEAR, PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
HER SPOUSE, HEIRS. ASSIGNS AND
CITY RS
APPLICANT.ON BEHALF OF HIS
. ENG. INSPECTION FEE
HE OF
NI FEND AND HOLD HARMLESS THE CITY OF
i IN INTEREST. AGREES INDEMNIFY,
AND
LANDSCAPING
S. SFROM ANY
EDMONDS.Y/ASHINGTON. ITSOFFICIALS. EMPLOYEES. AND
N
INSPECTION FEE
DIRECTLY
I ALLCLAIMSFORDAMAGES OF WHATEVER NATURE.ARISING DIRECTLY ORINDIRECTLY
NOT BE
RECEIPT
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUI REMENT OF ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFO ROE AN Y ORDINANC E PROW SION.
TOTAL AMOUNT DUE
gECEIPT ^ s�
J 2S / S
I HEREBY 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
Tnrs—Il,-1— is 1-1 a 1-1-1 until mgnee Oy Ina
THE OWNER. AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CDNS T RUC
CALL
9111-9 OlOeial or 01111,11 OPpply'. and Fq a,P pale. and
TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON'VAL BE EMPLOYED
TO
INSPECTION eaipt is pwlPdgPE �� sPacp PrpY�eee.
IN VIOLATION OF THE LABOR CODE OF THE STATE OP WASHINGTON RELATING
WORKMEN'SCOMPENSATIONINSURANCE AND ROW 18.27.
FOR
OFFICI SSIGNA E"\ 0 TE
(425)
`/ Z,t) U3
TUR ER 1 DATE SIGNED
_
_2_0
DATE
771-0220
�PELEASEDBI
EXT 333
-- --
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771'0221
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
IGINAL FILEA
ORPNK- ASSESSOR INSPECTORYELLOW -
FINAL
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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RECORD OF INSPECTIONS
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INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
IFooting ......................
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ez
Wall .]t
g,
Pier/Porch
Retaining Wall ........... O
Slab Insulation ......... O, �`
m � .
PLUMBING:
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Underground ............. W =
o m I,
Rough -In R1 O
Commercial Final ...... - I a [r
rn HEATING: M m
• Gas Test 0 I �'
C:
Gas Piping t [
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Equipment .................
Commercial Final ....... ��,t'
EXTERIOR SHEATHING IT m..
x�
NAILING
O y,
Or! �...
FRAMING ........................ O 0)
FIRST FLOOR FRAMING... Z
—I L
INSULATION ............ ..
� 4
Floor Insulation. 1
a
Wall Insulation ...........
Ceiling Insulation ....... _•
SHEETROCK NAILING ... Z.
SPECIAL INSPECTION
n 4'.
m
.. MISCELLANEOUS
ry
tpp FINAL APPROVAL FOR Vy1S Q _
3 OCCUPANCY .................. 4
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