20000721.pdf,-7 DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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113 1 ., I PERMIT EXPIRES
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NUMBER
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PILAT NAMEISUBDIVISION NO.
LOT 10,
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REMARKS
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FIRE REVIEWED BY
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— SHOREUNE.RACGII INSPECTION 80 D
STATE LICENSE NUMBER HE KEDBY
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(Fr.) PROPOSED SETBACKS (FT)
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ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR
AUDITION C] COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
PARKING LOT AREA PLANNING REVIEWED DATE
REMODEL APARTMENT
SIGN
REO'D I PROVIDED
C] REPAIR 0 GRADING CYDS
0 FENCE
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DEMOLISH TANK
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REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO
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VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE
LOT SLOPE %
BUILDING
PLAN CHECK NO:
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADtNGIFILL
DOMAIN (CURBS. W WILLREQUIRE
SIDEWALKS, DRIVE AYS, MARQUEES, ETC.)
SEPARATE PERMISSION.
RCHARGE
PERMIT APPLICATI N! 1—AYS
PERMIT LIMIM I YE AR, PROVIDED WORK IS STARTED WITHIN 18D DAYS
ENG� REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
APPLICANT. ON BEHALF 0 F HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
ENG. INSPECTtON FEE
THE CITY OF
I 15Y. DEFEND AND HOLD HARMLESS THE CITY OF
N INTEREST. AD .. S To:ND.E-N ANYAND
FROM
LANDSCAPING
ED ... S. WASHING.. IS IFICALS. EMPLOYEES, AND AGENTS
ALLCLAIMSFORDAMAGEsor,wHATEVER NATURE, ARISING DIRECTLYORiNDIRECTLY
INSPECTIONFEE
RECEIPT
FROM THE ISSUANCE Or THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
CEA Y REQUIREMENT OF ANY CITY ORDINANCE
DEEMED ToMoolFY. WAIVE OR FEDU N VISION.'
Pro
PT
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE
TOTAL AMOUNT DUE
READ THIS APPLICATION; THAI THE INFORMATION
APPLICATION
APPROVAL
IHERE Y ACKNOWLEDGE THAT � HAVE
GIVEN CORRECT. AND THAT AM THE OWNER. CRATES oULRAUT"GRINIED AGE 1 .1
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ThIlIPPI-t- -It iI 11,ed by th*
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THE OWNER AGREE To COMPLY WITH CITY AND NSTRUC
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FOR INSPECTION
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHMOTo
WORKMEWS COMPENSATION INSURANCE AND RCW 18 27.
OPR ALS SIG U RE
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CAT
771-0220
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING On STRUCTURE UNTIL
771-0221
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FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELLOW INSPECTOR
A
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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DESCRIPTION OF WORK TO BE IR�N SPEC t-13 7—
A field inspection was conducted to determine compliance with approved plans, Final approval. denotes that
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Lic. # FILCOCIOS ORUEXP.
Filoo Company Inc. IFCI LAW= #
PO Box 31228
SeaWc WA 98103 City License #
206-547-8347
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Cut off or remove vent and flUer pipes and cap them permanendy grade.
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pump OIA one _fflUon underground oil tank. E-Avatc and remove tank then back fiU
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ................
Pieriporch 7"
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Retainlrig Wall ...........
Slab Insulation ..........
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PLUMBING:
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Underground .............
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Rough -in ............
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Commercial Final
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
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Commercial Final
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EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ...............
FIRST FLOOR FRAMING
INSULATION ................ . .
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Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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USE
CITY OF EDMONDS ZONE
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CONSTRUCTION PERMIT APPLICATION ADDRESS
PERMIT
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OWNER NAM INA NESS
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PI -AT NAMEJSUBDIVISION NO.
LOT NO.
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LID FEE S
MAILING ADDRESS
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CITY ZIP TELEPHONE
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED -
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METER SIZE
LINE SIZE
NO. OF FIXTURES
PRY REQUIRED
NAME
ADD ESS
REMARKS
OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP
TELEPHONE
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ENGINEERING REVIEWEDIDATE
ADDRESS
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FIRE REVIEWED By DATE
CITY ZIP
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TELEPHONE
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SHORELINE OR ADS.
INSPECTION
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OYES ONO
POSTED
STATE LICENSE NUMBER
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$EPA REVIEW
COMPLETE EXEMPT
EXP
ALLOWED I PROPOSED
HEIGHT
ALLOWED , PROPOSED
PROPERTY TAX ACC04NT PAR�L 11,
NEW PLUMBING I MECH
C MPLIANCE OR
0 ADDITION COHANGE OF USE
REMODEL SIGN
0 REPAIR C] GRADING CYOS C3 lElCl X IT)
C] DEMOLISH TANK
ci GARAGE 0 PETAININGWALL RENEWAL
CARPORT
LOT C VER GE
ALLOWED 0 PROPOSED
REQUIRED SETBACK SIT
FRONT SIDE REAR
I
PROPOSED SETBACKS (Fr.)
FRONT UR SIDE REAR
PARKING
REQ D I PROVIDED
LOT AREA
PLA NING REVIEWED By DATE
-REMARKS
(TYPE OF USE, BUSINESS OR ACTIVITY� EXPLAIN:
WIV D"Coel'!L .
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SPECIAL INSPECTOR
JAREA I OCOUPAN I
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DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS
PER UBC 108/FINAL INSPECTION FIEO'Dl
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VALUATION
FEE
PLAN CHECK FEE
LOT SLOPE I
BUILDING
D,
STED DATE
PLUMBING
M M5CHANICAL
'CHAN'CAL
PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
3RACINGIFILL
DOMAIN (CURDS. SIDEWALKS. DRIVEWAYS' MARQUEES, ETC,) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATIOK:j 180 -Ay�
PERMIT LIMIT.- 1 YEAR. PROVIDED WOR S STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
PLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
ENO. INSPECTION FEE
;A DEPEND AND HOLD HARMLESS THE CITY OF
NPINTEREST, AGREES TO
LANDSCAPING
�NDEMNWY.
2 EDMONDS, WA HINGTON, TS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
-AtMSFOS D�MAGESOF WHATEVER E. ARISING DIRECTLY OR INDIRECTLY
ALL C IS NATUR E OF THIS PERMIT SHALL NOT BE
FROM THE SUANCE OF THIS PERMIT. ISSUANO
PLAN ECK DEPOSIT
DEEMEOTO MODIFY. WAIVE OR REDUCE ANY REQUIRE VENT OF ANY CITY ORDINANCE
ENFORCE ANY ORDINANCE PROVISION,
FT
0 NORLIMITINAN WAY THE CITY'S ABILITY TO
Y
TOTAL AMOUNT DUE
I
I
AT READ THIS APPLICATION; THAT THE INFORMATION
I HEREBY ACKNOWLEDGE TH -
APPLICAl ION APPROVAL
:HAVE
GIVEN IS CORRECT, AND TR AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
AT
by
THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC -
CALL
fh., op,ty: I.d Foo—, PlId. a�d
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TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
RELATING TO
opI,l 11--I'DI p,bvld.d
FOR INSPECTIOl
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
AT
I WORKMEN S COMPENSATION INSURANCE AND RCW IB.2T
AT
(4255)
OFF1 LS S19NATLtRE
-.j
771-0220
R EASED By
EXT 333
ATTENfl-ON
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI�
O�IGINAL-FILE YELLOW INSPECTOR
A
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
PINK OWNER GOLD -ASSESSOR
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