20020002.pdfDATE RECEIVED
USE
CITY OF EDMONDS ZONE 'E""ET,2p0'12
CONSTRUCTION PERMIT APPLICATION JOB SUITE/ TO
ADDRESS<)
�MOF 2ESS
PLAT NAMEtSUBDIVISION NO, LOT NO, 1,111 NO
ING ADDRESS LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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TELEPHONE EXISTING — PROPOSED
RE.W.F. DEDICATION—
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STATE
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DATE
EW
N ESIDENTIAL 09��LMSING
LOT OVERAGE
- I I ED SETBACKS IFT) I PROPOSED SETBACKS (FT I
RETIONT
I MECH
ALLOWETC PROPOSED I SIDE REAR FROM LAR sm REAR
COMPLIANCE OR
ADDITION COMMERCIAL CHANGE OF USE
...
L[O]APARTMENT
I
REMODEL P SIGN
ARKING
BEG' P PROVIDED
LOT REA PLANNING REVIEWED By DATE
EPAIR Ej GRADING
eyes 0 FENCE
)971 ( — X FT)
I
REMARKS
0 DEMOLISH 0 TANK OTHER
GARAGE o RETAINING WALL 0 FWN.L
CARPORT DOCKERY
(TYPE OF USE, �U E ACTIV" EXPLAIN:
iE
CHECKE BY ITYP:p
"ONN/ [ON C UFA
GROUP
177 0 1: X3
NUMBER NUMBER OF CRITICAL
OF DWELLING
SPECIALiINSPECTOR
OCCU NI
STORIES UNITS =R
RS.0 B [3 YES
JAIIEA
LOAD
DESCRIBE WORK TO BE DON 7_� 14'�
1(p 1%1'.
REMARKS
PROGRESS INSPECTIONS PER USC 11081FINAL INSPECTION REDID
3008cription
5�*Jj� CA3
W vnm�A_'
VALUATION $
FEE Description FEE
Plan Check
TLUSCE GLAZING LOT SLOPE %
Building
::r __rED DATE
PLAN CHECK NO:
PIU mbing
70
Mechanical
THIS PERMIT AUTHORMES ONLY THE ORK NOTED. THIS PERMIT COVERS WORK
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 1, ONUUN (CURDS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
Grading
Recording Fee
SEPARATE PERMISSION.
PERMITAPPLICATiONk
Engr. Review
City Surcharge
INDAYS
PERNITUM I YEAR -PROVIDED WORK IS STARTED WITHIN INDAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
State Surcharge
-PLICAK ON BEHALF OF 1111 OR HER SPOUSE. HEAR, AGsI.NS AND tiUCCEDOIRS
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Traffic Mitigation
—
Plan Chk Deposit
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FRO ANY AND
Fire Review
Receipt #
I I
IM
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
S
FROM THE I SUANCE OF THIS PERMIT. ISSUANCE F I HIS PERMIT SHALL NOT HE
NOT HE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
I NC,
Fire Inspection
Total Amount Due
0
0 = NORLIMITINANYWAYTHECnYSABIUTY 0 ENFORCE ANY ORDINANCE PROVISION.-
I 'ON
",To
Landscapoinsp..
Receipt #
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION; THAT THE INFORMATION
T IM
GIVEN IS CORRECT, AND THAT AM THE OWNER, OR THE DULY AUTHOR ZED AGENT OF
T
j
APPLICATION APPROVAL
LY WITH
THE OWNER. I AGREE TO COMP CITY AND STATE LAWS REGULATING CONSTFIUC-
CALL
I hiii.pieflatienn I —I . panall until ing..al by 91.
TI--, All- IN DOING THE WORK —RIZED THEREBY N. PERSON WILL BE E LOYED
.P
_.p YS.
IN V,.,T,.N 0, THE LABOR CODE OF THE E OF WASHINGTON RELATING TO
Get ding Orient tu 1,13itief Deputy: and Fear ani paid. and
TION 1pt I—kamledriod in inited P—Ided.
FORINSPEC ",a
WORKMENS COMPENSATION INSURANCE AND RSCTWATIB.27.
[fA�11 =f(AGENT) DATE Sir
(425)
'/ _/
. .... �'IATUINE IZ2
771-02 20
RELEASED BY DATE
AT
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
ORGINA FILE - YELLOW - INSPECTOR
PINK - OWNER - GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
V
SETBACKS .....................
FOUNDATION:
Footing .. ....................
wall ...............
Pier/Porch ..............
Retaining Wall ...........
Slab Insulation
PLUMBING:
Yndargrou d ..............
n
Rough -in ...................
ITI
C 13
Commercial Final
rn
0
HEATING:
0
C
Gas Test ....................
IT,
M z
10-4
Gas Piping .................
C 2
Equipment .................
Commercial Final
EXTERIOR SHEATHING
On
nx
:0
NAILING ..........................
171 IR
0
FRAMING ........................
0
0
FIRST FLOOR FRAMING
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IT!
PL
INSULATION ...................
z 0
Floor Insulation
;U
Wall Insulation
Calling Insulation
z
SHEETROCK NAILING
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SPECIAL INSPECTION
0
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................