20020011.pdfDATE RECEIVED,.
LPERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT
ZONE NUMBER XXII 1) 1
CONSTRUCTION PERMIT APPLICATION
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OWNER NAMEINAME OF BUS11 EBB
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PUBLIC RIGHT OF AY PER OFFICIAL STREET MAP
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLICRAINAGE
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LIC EXPIRATION DATE VAsA761 (14 CII 1HOWINE OR ADS# INSPE,0!10N I BOND
POSTED
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NEW
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REMARKS
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(TYPE OF USE, BUSINES:,�EXP�NW
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NUMBER
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PLAN CHECK NO:
VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORMS ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLXANYCONST UCIRONONTHEPUSLIC
Grading
OMAUN (CURES,
0 SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
SEPA
Ic RATIEPERMISSION,
a-
Engr. Review
MITAPPLICAYION: 180 DAYS
EAR � PROVI
PERMITUMMIYP ED WORK IS STARTED WITHIN WDAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPUCAN" ON 81-IF OF "IS 01 HER SPOUSE. HERE, ASSIGNS AND 11CC11011
Traffic Mitigation
IN INTEREST. A011111 TO INOEMN11, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY WA E ON REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
D NOR UMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapoinsip.,
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVE IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
T E OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC"
TION; AND !N DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
IN VIOLATION OF TH H STATE OF WASHINGTON RELATING TO
FOR INSPECTION
WORKME5;p COYPEN;4 �--N ANIE CW I.Z1_
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(425)
1:':;.eL .
771-0220
A17ENTION
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. USC SECTION 109
10101
FAX
Recording Fee I
City Surcharge 6
State Surcharge
Plan Chk Deposit
Receipt #
I Total Amount Due /6,0-
1 Receipt # InEd
APPLICATION APPROVAL
=, is not a permit until signed ty Lee
hismor Deputy: and Fees are Paid, and
!.fAff. DATE
ORIGINAL -FILE - YELLOW. INSPECTOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS
FOUNDATION:
Footing ......................
Wall ...................
Pier/Porch .................
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in .... . .............
Comme rcial Final
HEATING:
Gas Test ...........
jq
Gas Piping .................
�LV417�
Equipment
Commercial Final
EXTERIOR SHEATHING
NAILING
................
FRAMING
...............
FIRST FLOOR FRAMING
INSULATION ............
N^
Floor Insulation
Wall Insulation ...........
OX
Coiling Insulation
tA iO
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
D-5
OCCUPANCY ..................