20000331.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NA111MAMI 01 BUSINESS
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ADDRESS
CITY
NAME
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STATE LICENSE
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NUMBER
6
PERMIT EXPIRES
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PERMIT
200331
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NUMBER
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ADDRESS
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FRONT SIDE REAR
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SESIDENTIAL PLUMBING / MECH
ALLOWED PROPOSED
COMMERCIAL C] COMPL ANCE OR
CHANGE OF USE
—
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PAR ING LOTAREA PLANNING REVIEWED
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By DATE
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VALUATION __
FEE
PLAN CHECK FEE
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HEAT SOURCE GLAZING % LOT SLOPE %
BUILDING
PLAN CHECK NO: VESTED DATE
PLUN4BING
MEC14ANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTEM THIS PERMIT COVERS WORK 1.
BE ODNE ON PRIVATE PROPERTY ONLY. AMY CONSTAUCTIDN ON THE PUBLIC
GRADING/FILL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,� WILL REQUIRE
SEPARATE PERMISSION.
SURCHARGE
RMtT APPLICATION: 18� DAYS
T PERMIT LIMIT'. I YE APRE� PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENO, REVIEW FEES
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
'A ' AL"FHIS OR HER EPOUSE� HEIRS, ASSIGNS N S ES RS
"�"
INDE.Mll DEFEND AND P.LD RAN.L S I ITY F
SNO INSPECTION FEE
NG
TE..B Ft �. TO
INP'U'A'T�,'A
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2 EDMONDS. WASHINGTOM ITS OFFICIALS. EMPLOYEES, AND AGEN FR ANY AND
OFWHATEVE13NATUR ARISNG—
ALLCU�JMS FOR DAMAGES E' PERMIT SHALL NOT BE
EPOSIT
RECEIPT
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS
ANY REQUIREMENTOF ANY CITY ORDINANCE
PLAN CR
DEEMED TO MODIFY� WAIV E A REDUCE
CITY S ABILITY TO ENFORCE ANY ORDINANGE PROVISION.�
RECEIPT
0 NOR LIMIT IN ANY WAYTHr
TOTAL A,
0
I HERE Y ACKNOWLEDGE THAT I HAVE IEADTIEI"% ApPTL,�CEAT,�OLN� THAT THE IN' RMATION
APPLICATION APPROVAL
GIVEN" , ON D AUTHORIZED AGENT OF
'EC." F'ECT AND THAT' A. THE 0 -
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Y ENL.AW R'GU_T NG CON'Tnuc
THE CW El I AGREE I- COMPLY W" CIT �11�)
E_ L
CALL
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�STAT
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N' IN DOING THE WORK AUTHORIZED I. ESY� E
TION; A D o S' OGT.'� REILATPNc T-
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FOR NSPECTION
IN VIOLATION OF THE LABOR CODE 05 IN , 'TATE
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27,
0111c, S ATURE ATE
(425)
SIG OWNER OR AGE
211L771-0220
RE sio ey DATE
EXT 333
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORJA CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 09
FAX
PINK OWNER - GOLD -ASSESSOR
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Film COMPOny Inc. Lie, #FILCOCIOSORUEXR 10/10
PO Box 31229 IFCI Llcena� # im
SeaWe WA 98103 city Ucense
206-547-9347
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(Pump Clean and Fin)
13 Purnp & cleanone ____gallon underground oil tanIL FdlwithSWftvalPoWdbaWFoam
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Cut off or vermove, vent and filler pipes and cap flu- pennamently below rude
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Pump & clean one __gaffon underground oil tank Cut off or remove vent and pipes,
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and cap them permanently below grada
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pump out one 225--gallon undampowd oil tark Exeavau and mum tank then back fill
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the bale and dispDA of tank in proper manner.
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Al, FORM
APR 2 23 2000 TO:
DATE-
TAUMILDING DIVISION
MEMO TO: PERWr ORD
_ FIRE DEPART1�MNT DATE
'FROM: 4�
ENGINEERING DIVISION DATE—
LANNING DIVISION DATE —
PROJECT
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SITEADDRESS-
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PBMT __Z,,o __-----DATE INSPEC'I
�ADBM
PECTED—hL
DESCRIPTION OF WORK TO BE INS
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
ons from the above signed Department to the granting of
there are no objecti
approval of the described work
_Final
Performance Bonds associated with the proj ect may be released
___=��__GRANT FINAL PROJECT APPROVAL
.GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
_FAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
�MIAT
_LL_RE-INSPECTED OUTSTANDING ISSUES - Gp-kM FINAL PROJEU I Arr
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