20020041.pdfA%ii( DATE RECEIVED j PERMIT EXPIRES
USE PERM T
CITY OF EDMONDS ZONE NUMBER 9—OZ
CONSTRUCTION PERMIT APPLICATION JOB 1,U SUITEYAPT#
as ADDRESS 913Le /0111 6vz
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PUT NAMEISUBDIVISION NO. LOT NO. LID NO.
11. FEE I
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP E111':
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CITY ZIP JELIPHONE PROPOSED�
REQUIRED DEDICATION— FT
NAME — -Im — w1us.ont—
METER SIZE LINE 1111 1 N& OF FO(TURES PRV SQUIRED
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ADDRESS REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR MOSI OLIORAINAGE
/ 1114-1-1,411 - I'll ..
CITY ZIP ITELEPH..E Af 43�_,
NAME
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ENGINEERING REVIEWEDYDATE
ENGINEERING
ADDRESS
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FIRE REVIEWED BY DATE
FIRE REVIEWED BY
CITY Zip
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INSPECTION
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So No
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SIGN AREA
HEIGHT
ALLOWED , PROPOSED
PROPERTY TAX ACCOU PARCEL NO.
0 NEW jg—RESIDENTIAL 0 PLUMBING I MECH
[3 ADDITION 0 COMMERCIAL Ei C MPLIANCE OR
CHANGE OF USE
0 REMODEL APARTMENT 0 SIGN
Ei FENCE
0 REPAIR [j GRADING CYDS ( X Fri
ADEMOLISH TANK [3 OTHER
CGARAGE R ING WALL
ARPOAT REOTAINERY [:1 REN.L
LOT COVEMAGE
ALLOWED PROPOSED
REQUIRED SETBACK$ (FT)
FRONT SIDE HEAR
PROPOSED SETBACKS (FT.)
R SIDE
FRONT U HEAR
PARKING
REOTI I PROVIDED
LOT AREA
I PLANNING REVIEWED By DATE
REMARKS
OWE OF USE, BUSINESS PLAIN:
757
CHECKED BY
ITYP;MTION
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CCUPA,
GROUP ;4�,3
NUMBER
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do OF
9 —STORIES
NUMBER OF
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UNITS
SPEC[AL.I.NSPECTOR
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-C�C.UPANT
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DESCRIBZ,.RK TO SUONE
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REMARKS
PROGRESS INSPECTIONS PER USC 1081FINAL INSPECTION REOD
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VALUATION $
Description
FEE
Description
Plan Check
HEAT SOURCE GLAZING %
LOT SLOPE %
Building
PLAN CHECK NO:
VESTED DATE
Plumbing
Mechan,ca'
Mechanical
THIS PERMIT AUTHORIZES ONLYTHE WO KNOTED. THIS PERMIT COVERS WORKTO
t: 11 DONE I" PRIVATE PROPERTY C.11. ANY CONSTRUB11.14 ON THE PUBLIC
IS DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MAROU Etc.) WILL REQUIRE
SEPARATEPERMiSSION. EES,
PE MITAPPLICATION: INDAYS
PERMIT LMIr. I YEAR PROVIDED WORK 15 STARTED WITHIN had DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
GadH.
Grading
Recording Fee
Engr. Review
Engr Rek"-W
City Surcharge
Engninspection
State Surcharge
'APPLICAW, ON BEHAL OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS MOM ANY AND
Traffic Mitigation
Plan Chk Deposit
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECT
Fire Inspection
Total Amount Due
FROM THE ISSUA CE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT
DEEMED To MODIF� WAIVE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINAN
0 NOR LIMIT IN MY WAY THE CiTYS ABILITY TO ENFORCE ANY ORDINANCE PROVISIO
Landscapoinsp.1
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFOR F
GIVEN IS CORRECT, AND THAT I AM THE OWNER, 08 THE DULY AUTHORIZED A T
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING C T
TION; AND IN DOING THE WORK AUTH RIZED THEREBY. NO PERSON WILL BE E
IN VIOLATION 01 THE LABOR Cool OF THE STATE 01 WAIHINCTON RELATING To
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ALL
FOR INSPECTION
APPLICATION AP Pi
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Building olfia�tfl ou husihor Doploy: old I
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WORKMEN'S COMPE,S:=RA CE A RCVV 1017.
(425)
011111ALSU
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DATE S IGNED
1-17- _
1 771-0220
REIASED BY
ATTENTION EXT 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221 ORIGNAL-FILE YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ..............
wall .......... I ..........
PierlPorch ..........
-4
Retaining Wall ...........
Stab Insulation
PLUMBING:
Underground
M
5
Rough -In
IT!
0
...................
-40
Commercial Final
M
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HEATING:
0-4
GasTest ....................
Gas Piping .................
Equipment
Commercial Final
RIM
EXTERIOR SHEATHING
a
0
NAILING � .........................
01-1
FRAMING ........................
a
Q 0
FIRST FLOOR FRAMING
INSULATION _ ..........
;U
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
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SHEETAOCK NAILING
SPECIAL INSPECTION
ITI
MISCELLANEOUS ..........
FINAL APPROVAL FOR (VI
OCCUPANCY ..................