20010929A.pdfDATE RECEIVE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
FAA&IMERIAME OF BUSINESS —
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PERMIT EXPIRES
PERMIT
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15
REMARKS
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REMARKS
REMARKS
DEMOUSH 0 TANK OTHER
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PROGRESS INSPECTIONS PER UBC IGO/FINAL INSPECTION REO'D
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Description
FEE
Description
FEE
Plan Check
HEAT SOURCE GLAZING . LOT SLOPE %
Building
PLA14 CHECK NO: VESTED DATE
Plumbing
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THIS PEFNMT AUTHORIZES ONU THE WORK NOTED. THIS PERMIT CCVRERS WORK TO
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It BE DONE ON PRIVATE PROPER11' ONLY. ANY CONSMUCTION ON THE PUBLIC
a
DONAiN (CURZS.SIDEWALKS,DRIVEWAYS UEES. ETC.) WILL REQUIRE
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Grading Recording Fee
Grading
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PERUIIIAPPUCATION: INDAYS
PEBUTTLIMIT11 YEAR-PROWDEDW RKISSTAIRTEDWITHIN IeDDAYS
SEE BACK OF PINIK PERUrr MR MORE INFORWIAITON
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-APPLICANT, ON BEHA1 OF His OR HER SPOUSE, HEIM, ASSIGNS AND SUCCESOM
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IN INTEREST, AGREES TO 11 DEMNIFY. DEFEND AND HOW HARMLESS THE CITY OF
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EDMONDS. WASHINGTON. ITS OFFICLAI_S. EMPLOYEES. AND AGENTS MOM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. MSING DIRECT1Y OR INDIRECTLY
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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DEEMEOTO MODIFXWAIVE OR REDUCE ANYREQUIREMENTOFANYCITY ORDINANCE
0 NOR LIMIT IN CITYS ABILITY 10 ENFORCE ANY ORDINANCE P.-'SIM
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Traffic Mitigation Plan Chk Deposit
Tnafific Mitigation
Fire ".view Receipt#
Fire Review
Fire Inspection Total Amount Due
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BY ACKN "A"ON
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THE OwNE I AGRE 0 COMPLY WITH CITY AND STATE LAWS REGULATING CONSTR
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IN Do, G E EMPLOYED
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APPLICATION APPROVAL
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RELEASED BY
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EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI. 771-0221 ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK - OWNER GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
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SETBACKS .....................
FOUNDATION:
Footing � .....................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commbrclal Final
HEATING:
Gas Test ..........
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
1
NAILING ..........................
FRAMING
'Fjpt6iliLOOR FRAMING_
Floor Insulation
Wall Insulation ...........
Calling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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DATE RECEIVED :0 PERMITEXPIRES
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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CITY ZIP
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REQUIRED DEDICATION— FT
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NAME
METER SIZE
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ADDRESS
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EMARKS
WNERICONTRACTOM RESPONSIBLE FOR EROSION CON'rFtOLIDRANA-E
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ALLOWED I PROPOSED
PROPE TAX Acco PARCEL NO.
EXP I
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ALLOWED PROPOSED
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FRONT SIDE REAR
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FRONT LJRSIDE BEAR
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ADDIT MMERCIAL CIE
'or' 1:1 CHANGE OF USE
P- FIXING LOT AREA PLANNING REVIEWED By DATE
REMODEL APARTMENT EI SIGN
REOD I PROVIDED
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171 1 X FT)
REMAR
(3 DEMOLISH 0 TANK OTHER
GARAGE RETA�NiNG WALL RENEWAL
CARPORT DOCKERY
M?E OF USE, BUSINESS OR EXPTAH,i:
CHECKED BY
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—ITUMBER
—NUMBEFI OF
DWELLING
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SPECIAL INSPECTOR
OCCUPANT
OF
STORIES
I U NRS
NUMBER
JAREA
REQUIRED [j- YES
LOAD
DESCFLBE WORK TO BE DQN�
REMARKS
PROGRESS INSPECTIONS PER UBC 10111FINAL INSPECTION RE(YJD�
'L PURS U,'I`.NT'r0 ECDC 19
�tRMULA2C)RVAL (pRV)
SHALL
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VALUATION $
FEE
Descriptlo.
FEE
Plan Check
GLAZING LOT SLOPE Building
PLAN CHECK NO: Plumbing
Mechanical
MSurchatga
stUf THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: TtUS PERMIT ALITHORIZES NONTHEPUR C Fee
Be DONE ON PievAn PROPERTY ONM AM CQNSTRWTno
3 DOKWN (CURBS, SIDEWALKS, ORWEVAYS, I,UUROUEES, ETC.) WILL REQUIRE
SISPASUITEPEAMISSIO
i Lm Eqgr. Review City
PERMIT Umm I PERMIT APPLI�Tl M. too DAYS
YUA - PROIRDED WORK 95 STARTED WrTHIN IWDAYS Engr. Inspecti n StateSurcharge
SEX BACK OF PIW PEMIT FOR MORE INFORMATION
-APPUGMT ON BEHALF 0 HIS OR HER SPOUSE, HEIRS, ASSIGNS MO SUCCESORS Traffic Mitigation Plw Chk
1. I —RE- AGREES TG'11BMNI- DEFEND AND ..- HARMUESS THE CITY .1 Receipt III
EDMONDS, WASHINGTON I ITS OFFICIALS. EMPLOYEES, MO AGENTS FROM ANY' AND Fire Review
ALL MAJUS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Fire Inspection T.Jej Amount Due
DEEMED TO MODIFY, WAPIE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR — IN Receipt #
ABILRY TMENICIR(CE ANY ORDINANCE P.CVISI.-� Landscapeinsp.
I HEREBY E E HAVE READ THIS APPILICATION: THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CT, AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This Wkag� Is — 0 Pc� W" sjg� by ins
THE OWN I AGRE 0 COMPLY WITH CITY AND STATE LAWS REGULAnNO CONSTRUC- CALL ,,d,,g 0,,X,, m hLqha, OWvty; Md F� us PAW. UA
TON;M THE WORK ALInHORIZED THEREBY. NO PERSON WILL BE EMPLOYED 's-iPjis�0dg�dhsPsosPIm&Im-
IN VIO ION THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
we R MKNSATIOWIgSU DATE
ANCE AND RCW 1827 OF'11117 BIDNA� E
(425)
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RELEASED By ATE
AtTENTION- E)U 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. YELLO
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
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