20020052.pdf: DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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USE PERMIT
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PLAT NAMEISUBDIVISION NO. I LOT NO, L
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LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED —
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REQUIRED DEDICATION— FT
METER SIZE I LINE 1111 1 NO� 01 FIXTURES 'EP REQUIRED
SO NO 13
REMARKS
OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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ALLOWED PROPOSED
HEIGHT
ALLOWED , PROPOSED
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LOT C VERAGE
ALLOWED 0 PROPOSED
REQUIRED SETBACKS (FT.)
FRONT SIDE NEAR
PROPOSED SETBACKS (Fr.
FRONT US SIDE REAR
ADDITION COMMERCIAL C MPLLANCE OR
CHANGE OF USE
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LOT AREA
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REMARKS
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CAR a AETAINING WALL
PO DOCKERY RENEWAL
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EIRROGRESS INSPECTIONS PER UBC IOEI/FINAL INSPECTION REITO
Plan Check
HE)IT SOURCE GLAZING % LOT SLOPE %
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Building
PLAN CHECK NO: VISITED DATE
Plumbing
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THIS PFAMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORKTO
BE ... old PRIVATE PNCIPSRTY ONLY. ANY CONEY UCTIONONTHEPUBUC
Recording Fee
.0&WN (CURB% SIDEWALKS. DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
S'PARATEPERMissio".
Engr, Review
City Surcharge
"Burr APPLICATION: IN DAYS
PERMIT LIMM. I YEAR - PROVIDED WORK IS STARTED WITHIN "10DAYS
Engr. inspection
State Surcharge
SEE BACK OF PINK PERMIT MR MORE INFORMATION
'APPLICANT, ON BEHALF OF HI On HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREES To INDSEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON ITS OFFICIALS, EMPLOYEES, AND AGENTS FRO ANYAND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY ORM
,,,IND RECTLY
FROM THE I SUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT U. NOT E
Fire Inspection
Total Amount
9 DEEMED TO MODIFY; WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANDE
01 NOR LIMIT IN ANY WAY THE CITY$ ABJUTY TO ENFORCE ANY ORDINANCE PROVISI N.-
LandscapoInsp.
Receipt #
I HERE ACKNOWLEDGE THAT I 14AVE READ THIS APPLICATION; THAT THE INFORM ION
GIVEN 19 CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
Thin.ppl iunk,n K.0 n P-11.01 iii9rInd by Inn
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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WORKMEWS COMPEqSAV"SU NCE AND NOW 18.27�
FFICIALS SIGN711 DATE
SIG�� :E1. SIGNED
(425)
2-1-el 2--
RELEASED BY OAfE
ATTENTION
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-
ORIGINAL - 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
SETBA^-KS .....................
FOUNDATION:
Footing ......................
Wall...........................
Pier/Porch .................
171
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
3:
M
M 0
Underground .............
0
0
Rough -in ..........
-4
X M
ITI Z
Commercial Final
'0-4
C: —
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HEATING:
;i,
Gas Test ....................
Gas Piping . ................
Equipment ................
M M
Commercial Final
0 ra
0 r-
0
EXTERIOR SHEATHING
NAILING ..........................
Q 0
FRAMING ........................
z
FIRST FLOOR FRAMING
ANSULATION ...................
z
Floor Insulation
Wall Insulation
z
9
Ceiling Insulation
0
SHEETROCK NAILING
IT
SPECIAL INSPECTION
j
MISCELLANEOUS
FINAL APPROVAL FOR
ll-07
OCCUPANCY ..................
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