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0
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L BE DONE ON PRIVATE PROPERTY ONLY. AN' CONSTRUCTION ON THE PUSUC
I W I ' MAR UEES ETC I WILL REQUIRE
DOMAIN (CURBS. SIDEWALKS, OR YEWAYS4,MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
GRADINGIFILL
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SUFIC ROE
STATE SURCHARGE
N: '60 DAYS
PERMIT APPLICATION ". DAYS
OW . W R SST . W. .. DAYS
PERMIT LIMIT: I YEAR * PROVIDED WOO IK IS STARTED WITHIN 180 DAYS
M
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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END, INSPECTION FEE
'APPLICANT. ONBEHAL OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
ALLCLAIMSFOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THEISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMEDTO MODIFY, WAIVE OR REDUCE ANY AEGUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CIII'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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LANDSCAPING
1N.SPECTIONFEE
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PLAN CHECK DEPOSIT
RECEIPT
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RECEIPT/f�7
(HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
AUTHORIZED AGENT OF
APPLICATIOI
GIVEN ISCORRECT� ANDTHATI AM THE OWNE .0 E In —PP — - 12"1 "y"'.
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL B..Id.ng Off —I 11 ,"h,, Dap,ay and Fa,, ,a vani. no
TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED FOR INSPECTION
IN VIOLATION OF THE LABOR CODE OF IKE STATE OF WASHINGTON RELATING TO zapt is awowl0dig1d,n pace P,dad
WORKMEN S COMPENS=URANCE AND RCW 18, 7 01FIC14LS Sli ATURE A)E
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ATTEIAON EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. LISC SECTION 109 FAX PINK -OWNER - GOLD -ASSESSOR
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INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final
HEA`nNG:
Gas�Test d. .................
Gas Piping ...............
Equipment ..............
Commercial Final
E)(TERIOR SHEATHING
NAILING ..........................
FRAMING r .......................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall insulation ...........
Ceiling Insulatlon
SHEETROCK NAILING
SPECIAL INSPECTION
FINAL APPROVAL FOR
OCCUPANCY ..................
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—,I-- RECEIV�D 41,91 10F_RMIT EXPIRES
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USE PERMIT
CITY OF EDMONDS NUMBER
CONSTRUCTION PERMIT APPLICATION J08 SUITEJAPTO
— ADDRESS 40-4 MCI* I n LIDNO.
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PRV REQUIRED
NAME
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FIRE REVIEWED By
VARIANCE OR CU
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DATE
SERA REVIEW
COMPL17E I EXEMPT
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SIGN AREA
ALLOWED I PROPOSED
ALL'
HEIGHT
ALLOWED PROPOSED
ROOPERMAX AGWOUNTPARCEL.O.
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0 RESIDENTIAL LU.SING
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ALLOWE02PROPOSED
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FRONT SIDE REAR
PROPOSED SETBACKS (FT.)
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BY DATE
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STED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT DOVERS WORK TO
L BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
GRADINCIF11,L
DOMAIN (CURBS, AYS, MARQUEES. ETC.) WILLREOUtRE
SIDEWALKS, DRIVEW
:3 SEPARATE PERMISSION,
STATE SURCHARGE
PERMIT APPLICATION 120DAYS
PERMIT LIMIT. I YEAR ' PROVIDED WORK IS STARTED WITHIN 100 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENO. INSPECTION FEE
-APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
FROM ANYAND
LANDSCAPING
EDMONDS, WASHINGTON. ITSOFFICIALS. EMPLOYEES. ANDAGENTS
ALLCLAIMS FOR DAMAGESOF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
INSPECTION FEE
RECEIPT
FR M THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
0
PLAN CHECK DEPOSIT
0 DEEMED To MODIFY. WAIVE 0 REDUCEANY REQUIREMENTOF ANY CITY ORDINANCE
I VISION.-
0 NOR LIMIT IN ANY WAY THE CITY S ABILITY TO ENFORCE ANY ORDI NANCE PROVISION.
IN
RECEIPT
TOTAL AMOUNT DUE
DOE THAT: HAVE READ THIS APPLICATION: THAT TH E INFORMATION
APPLICATION
APPROVAL
1 HEREBY ACKNOWLI
GIVEN IS CORRECT. AND THAT A. THE OWNER. OR THE GLI AUTHORIZED AGENT OF
THE OWNER. I AGREE C MIL' WITH CITY AND STATE LAWS REGULATING CONSTRUC
TO 0
CALL
Off,cial ,, m�., D.P.ly ld F ,, P, d
TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EIP -YED
OF WASHINGTON RELATING TO
FOR INSOPECTION
I
IN VIOLATION 01 THE LABOR CODE OF THE STATE
WORKMEN'S COMPENS=URANCE AND RCW IS.. 7.
_jFFICIALS SI ATURE
QNATLJ�17:4t'l'
1�
1
(425)
771-0220
DATE
R LEASE
EXT 1333
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL IN SPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORiGINAL-FILE - YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN RANTED. UBGSECTION109
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FAX
NER - GOLD -ASSESSOR
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