20020013.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PERMIT EXPIRES
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PUT NAME]SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE Ir
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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EXISTING — PROPOSED
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REQUIRED DEDICATION— FT —
METER SIZE
LINE SIZE
NO. O�F FIXTURES
PRV REQUIRED 0
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FIRE REVIEWAVY-��'_' E
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STATE LICENSE NUMBER
EXPIRATION DATE - BY
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VARIANCE OR CU SHORELINE OR ADEN INSPECTION
ST
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'3Y.E.'
ED 13 NO
PROPERTY TAX ACCOUNT PARCEL 110.
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT LLOWED PROPOSED ALLOWED PROPOSED
EXP I
0 NEW
RESIDENTIAL
LUMBING I MECH
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACK$ (FT,
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR)
ADDITION
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Ei C MPLIANCE OR
ORANGE OF USE
0 REMODEL
APARTMENT
0 SIGN
2 DATE
O'BEPAIR
GRADING
[3 F NCE
IFF
0 — eyes
( _ X FT)
REMARKS SHALL BE INSJALLED ON THE
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LIVE AS ITC'RrS79TRFUMMEW�
,3 PANAGE
RETAINING WALL
CARPORT
3 ROOKERY
RENEWAL
UWE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
NSTRUCTION OCCUPANT
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AREA
SPECIALE)ONSPECTOR OGCU NT
6T.WES
UNITS
NUMBER
JAREA
REOU R [3 yea LOAD
DESCRIBE WORK TO BE DONE
REMARKS
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9 1 1 Deacriation I FEE
HEAT SOURCE GLA4112
LOT SLOPE %
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Building
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IESTE. DATE
Plumbing
PRURN�g
THIS PERMIT AUTHORIZES ONLYTHE WORK NOTEM THIS
PERMIT COVERS WORK TO
Mechanical
Mechanical
t BE DOME ON PFRVATE PROPEFM ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
-radim.
Recording Fee
M G OMAIN (Curies, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILLREGUNIE
SEPARATEPERMISSION.
Engr. Review
City Surcharge
MIYAPPLICATION: INDAYS
Ln
PERMBiUMMIYELPEPROIRD D WORK IS STARTED WITHIN INDAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF 011111 OR HER SPOUSE. HEIRS A SUCCESORS
Traffic Mitigation
Plan Chk Deposit
I
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD'HAIGRNSLEMSE'THE CITY OF
EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE I SUANCE OF THIS PERMR. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
" 'napach
Fire Inspection
Total Amount Due
x NOR LWIT IN ANY WAY THE CRY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapainsp.
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
—
APPLICATION
APPR
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GIVEN 15 CORRECT;AND THAT IAMIHE OWNER, OR THE DU AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTFIUC-
CALL
This appliCRU.n Is nt . p-11 Mil -19.md by M.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATI N OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
BlltdjPgoiij�1.1., belb., D.p.ty: nd F�. .. p.'L nd
'ec,lpt Is ack—lodri,d I, spac, jXmided.
WORKMENS COMPENSATION INS�� CW 1817.
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EXT 1333
fr7filTION
IT IS LAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
1 0 1-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
ORIGINAL - FILE YELLOW, INSP60TOR
CATE OF OCCUPANCY HAS BEEN GRANTED, UBG SECTION 109
FAX
PINK � OWNER - GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ..................
................
Pier/Porch ................
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Retaining W411 ...........
Slab Insulation
PLUMBING:
'A 5i
Underground ............
4
3:
M
C
Rough -in .................
M 0
0
Commercial Final
0
HEATING:
M
M
aat ....................
Gas Piping
Equipment .................
0 n
-n
Commercial Final
:C
EXTERIOR SHEATHING
M IT!
a 6;
NAILING 3 ........ .................
0
0
FRAMING .................
C
FIRST FLOOR FRAMING
Q C),
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INSULATION..; .................
;U
Floor Insulation
Wall Insulation ...........
z
Ceiling Insulation
C4
SHEETROCK NAILING
z
SPECIAL INSPECTION
0
M
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................