20020038.pdfPERMIT EXPIRES
CITY OF EDMONDS .20 NERMM,1ETR )X2 LTI_
CONSTRUCTION PERMIT APPLICATION JOB
ADDRESS 12(3ce(v Tj11,q0+ jzP
OWNEME NrE OF BUSINESS
_ — , FLAT NAME/SUBDIVISION NO, LOT NO, LID N .
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MAILING ADDRESS LID FEE S
P BLIC RIGHT OF WAY PER F1ICIAJ STREET MAP
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66'
or, ZIP ITELEPHONE EXISTING — PROPOSED—
C--,J mnAs 17 90 ZJ6 I 6f 7- REQUIRED DEDICATION— Ft ED
NAME METER SIZE LINE 11 V REQUIRED
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ADDRESS REMARKS
WNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP ITILIP"ONI
NAME
ENGINEEIING REVIEWED/DATE
.7DDRESS
FIRE REVIEWED By AT'
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CITY PURSUANT TO UPC 605"
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STATE LICENSE NUMBER KED BY VARIANCE OR CSH
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$EPA REVIEW SIGN AREA HEIGHT
-PROPERTY TAX ACCOUNT PARC L NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
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LOT COVERAGE REQUIRED SMACKS (Fr. PROPOR D SETBACIV5 (n)
NEW BESH)MIA1 MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR
'LUM'"-s
DITION Me 'EU OR
0 COMMERCIAL S
0 AD E3 CHA BE 0 E
,.Z'\ PLANNING REVIEWED By DATE
MJEMKIDEL APARTMENT SIGN RE DC 19.30.020
PENCE YALVE(RIW
EPAIR E3 GRADING CyGS o I _ X PT) REMARKS SHALL BE INSTALLED NEAR
0 DEMOLISH 0 TANK 0 OTHER THE WAI'ER SHUMPF
o GA E [3 RETAINING WALL
RAG ROOKERY El NSNEWAL
CARPORT
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CUPAUTZ
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CHECKED BY IT'NITM111 07
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N7m—aEn_TWu_meER OF CRITICAL -
DWELLING SPECIAL INSIECTCR OCCU NT
ARIAS
IPROnAFSS
9
E..,.E. JAFIEA LOAD
GTOR UNITS NUMBER R 0 YES
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DESCRIBE WORK TO BE DONE
REMARKS
INSPECTIONS PER UBC 1081FINAL INSPECTION REaD
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FEE
I HrmT SOURCE J GLAZMIV% LOT SLOPE %
Building
4
PLAN CHECK NO: VEITsD DATE
Plumbing
Mechanical
THIS PERMIT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIME PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC
X D FISQUISE
OMAIN (CURBS, SIDEWALKS, DRIVEWAYS
SEPARATE PERU; "ARQUCES. ETC,) WILL
SSION.
MITAPFUCATI N; ISODAYS
PERMIT LIMM I YE MPE. PROVID D WORK IS STARTED WITHIN 1 80 DAYS
SEE 13ACK OF PINK PERMIT FOR MORE INFORMA710H
Grading
Engr. Review
Engr. Inspection
'APPLICAN�L ON BEHALF 011111 OR 1111 SPOUSE, HEIRS, ASSIGNS AND 1UCCE1OR1
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS Fort DAMAGES Of WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE 01 THIS P11MI1 ISSUANCE 01 THIS PERMIT SHALL NOT "
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REOUIREMEffl OF ANY CIN ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
Tre"IC M gation
Fire Review
Fire Inspection
Landscapeinsp.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN Is CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUT14ORIZED AGENT OF
THE OWNEM I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRuC.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, No IMON WILL BE EMPLOYED
IN VIOLATION OF THE "BOB CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
WORKMEN'S qqMfENSAIION INSURANCE AND RCW 18 27
SIONATU NEn E
(425)
7�O 0
0
771-0220
NTION
ENTI�
EX`T 1333
IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
I IS UNLAWF
FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
10101
City Surcharge
-S."Zt.
Plan Chk Deposit
Recei�t #
Total Amount Due
Receipt #
ICATION APP
aN.Manet.P.1.1-11
FEE
ad by Me
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ORIGINAL - FILE YELLOW - INSPECTOR
PINK . OWNER GOLD - ASSESSOR
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIR DEPARTMENT DATE
cow INEERING DIVISION DATE
PLANNING DIVISION DATE
PROJECT
SITEADDRESS
PERMIT # %7 007 —00:3 V ADD TEINSPECTED
DESCRIPTION OF WORK TO BE INSPECTED� .... . .......
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of:
Final approval of the described work
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
I Vow,
--FAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
_RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing. ......................
wall ...........
Pier/Porch ............
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Retaining Wall ..........
Slab Insulation ..........
PLUMBING:
Underground .............
RI
Rough -in ...................
Ma
0
0
Commercial Final
C
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HEATING:
M
IT! z
Gas Test ....................
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Gas Piping .................
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Equipment ...........
0 n
Commercial Final
IT! M
EXTERIOR SHEATHING
NAILING . ............. _ ..........
0
FRAMING ........................
0 Fn
M 0
FIRST FLOOR FRAMING
Z
INSULATION
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Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
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SPECiALINSPECTiON
R11
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ...............
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