20020028.pdfi 96
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PERMIT EXPIRES
USE
Zo PE
CITY OF EDMONDS NE URM T
IN MBER2Z2=-1M-,1
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
ADDRESS 1-7
OWNER NA�,INAME 0F BUSINESS
"0 FLAT 11A.C1.1J.D.S.11 Up 110.
MAILING AD BESS U FEE S
f;13 all S- PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP P..'s `Z"s.,
enn'. Vs. """ ""d
CITY ZIP ITELEPHONE EXISTING — PROPOSED — I
01 1 REQUIRED DEDICATION— FT — r.—a
Vndra,naad 13
NAME
NO. 01 FIXTURES
P" R
Al 0
YE.13 No 13
ADDRESS REMARKS
se
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
zip ITILIPHONE J,
3' _ ENGINEERING REVIEWED/DATE
0 se ADDRESS
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I - FIRE REVIEWED BY DATE
CITY
ZIP
TELEPHON
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STATE LICENSE NUMBER
qg,jes r-q 34 0 0 6
EXPIRATION DATE
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PROPERTY TAX -C UNT
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COMP
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PLUMBING 4-1�
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ADDITION
COMPLIANCE OR
GMNGE OF USE
REMODEL
SIGN
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[3 REPAIR
[3 GRADING CYOR 0 FENCE X Fri
I
MAI
_�E_
E] DEMOLISH
1771 TANK
0 OTHER
o CGARAGE
AIRPORT
RETAINING WALL [3 RENEWAL
0- ROOKERY
(TYPE OF USE, BUSINESS OR ACITWTY) EXPLAIN:
z OR cu SHORELINE OR ADS# INSPECTION No
BE.'. I PBOOTCI
[3YES 13NO
JEW SIGN AREA HEIGHT
EXEMPT ALLOWED
_LL_ I PROPOSED ALLOWED I PROPOSED
TRAM— -06"14 U SM(FT) PROPOSED SETBACKS I'M
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SIDJACK, n_ BE
FRONT SID
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CHECKED By JTYPERP'N�
OCUPANT
SOUP
In I
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NUMBER
OF
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0 ING
CRITi CAL
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SIEC-L.NSPECTOR
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OCCUPANT
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UMB�ER
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LOAD
DESCRIBE WORK TO BE
DONE
REMARKS
P '
PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REGO
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6-r-k
VALUATION $
FEE
— Cosuir- I GLAZING e6 LOT SLOPE
Building
I
PLAN CHECK NO: TED DATE
Plumbing
— ------ =====
Mechanical
THIS PERMIT AUTHORIZER ONLY THE ORK NOTED, THIS PERMIT COVERS WORK TO
t: BE ..r ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
Recording Fee
:3 DOMAIN (OURIPS, SiDEWAUCS, DRIVEWAYS, MARQUEES, ETC.I WILL REQUIRE
SEPARPTEPCHMISSION.
Review
PC N: ISODAYS
Engr.
City Surcharge
PERMIT LUMit I .?MITAPPUCATI
PROWD WORK'SSTAMDWQ.'. 'so DAYS
Engr. Inspection
State Surcharge
See BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLIC NL ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN 1111CS1.7, AGREES TO IN.E.1,111 DEFFN. AN. ..I. HARMLESS THE CITY OF
—
EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FO DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS ERMIT SHALL NOT BE
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT F ITY
C
Fire Inspection
Total Amount Due
OF ANY ORDINANCE
0. NOR LIMIT IN ANY WAY THE CHYS ABIUTY TO ENFORCE ANY ORDINANCE PROVISION. -
Landscapelnsp.
Receipt #
My
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPUCATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This appi.sts-fir ard.pendattindit signed by Me
TION: AND IN DOING THE WORK AUTHORIZED T CREW, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
ding Offie�al or his/her Capuryi add Fees eta paid, and
n-1pt 1, ackenefixited In spede pewided.
WORKMEN'S COMPENSAT%,WSLC��NCE AND now 10,27,
OFFICIALS SION DATE
_sIGNATUAS (OWNER O%!��* SIGNED
(425)
"URI
/Y
771-0220
RELEASED BY
WTTENTION
M 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
ORIGINAL,FILE - YELLO -INSPECTOR
PINK -OWNER - GOLD WASSESSOR
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Footing......................
Wall ....................
Pler/Porch .................
Retaining Wall
z
0
Stab Insulation ..........
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0
PLUMBING:
Underground .............
M
c 0
ommarcial Final
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0
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GasTest ...................
IT IT!
Gas Piping
Equipment
................ .
0 n
Commercial Final
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EXTERIOR SHEATHING
ITI IT!
NAILING .......... ...........
0 vi
FRAMING ......................
0
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FIRST FLOOR FRAMING
ITIO
Z
INSULATION ...........
Floor Insulation
Wall Insulation ..........
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Coiling Insulation
SHEETROCK NAILING
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SPECIAL INSPEC71ON
0
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MISCELLANEOUS ..........