20020060.pdf-1 DATE RECEIVED
CITY
ERMIT
�'SE PIUNIBEIR'J"Q��'
OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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ADDRESS
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OWNER NAMENAME OF BUSINESS
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CITY ZIP
NONE
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ENGINEERING
REVIEWETVDATE
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-CITY ZIP
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FIRE REVIEWED BY
DATE
I- Im In'OvII0
Y-/ I
STATE LICENSE NUMBER
EXPIRATION D ATE
VARIANCE 0 CU
SHORELINE OR ADB# INSPECTION IF No
RE o P STED
9 0Y,
YES ONO
;j PROPERTY TAX ACCOUNT PARCEL NO,
$EPA REVIEW
COMPLETE EXEMPT
SIGN AREA HEIGHT
ALLOWED PROPOSED ALLOWED PROPOSED
1
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0 NEW ESID NTIAL
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LOT COVERAGE
REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
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PLUMBING MECH
ALLOWED PROPOSED
FRONT SIDE REAR FRONT URSIDE REAR
ADDITION COMMERCIAL
o COMPLIANCE OR
REMODEL APARTMENT
CHANGE OF USE
SIGN
PARKING
0 1 P.01ME.
LOT AREA PLANNING RI IEWED By DATE
E] REPAIR GRADING o F NCE
CYDS
X FT)
REMARKS
I-] DEMOLISH E] TANK
GARAGE RETAINING WALL
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[:1 sE..L
CARPOaT ROCKERY
ITYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
11PROGRESS
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CHECKEDBY jTYp..1C.TTffTTION C?T.�?_ I
CRITICAL
AREA
SPECIAL INSPECTOR
OCCUPANT
NUMBER
REQUIRED 0 YES
JAREA
LOAD
I�K TIA.11
'�IFBIE
REMARKS
INSPECTIONS PER UBC IDS/FINAL INSPECTION REO'D
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Plan Check
HEAT SOURCE GLAZING I
LOT SLOPE 16
TED DATE
AD
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Building
Plumbing
Tift. PERMIT -I..R— ONLY T.. WO K ".Is.. 71,119 PERMIT COVERS WORK 10
Mechanical
BE DONE ON PRIVATE PROPERTY OXILY.ANYCONSTRUC71 ONONYHEPUSLIC
Grading
ChIMN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, r RE
-TC.)WILLREQUI
SEPARATE PERMISSION.
no, sov
Engr. Review
PS MITAPPLICATION INDAYS
PERMIT UMM. I YEAR -PROVIDED WORK IS STARTED WITHIN INDAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-PIIOANTF ON BEHALF OF HIS On HER SPOUSE. HEIRS, AISIGNI AND 1UGCESQR1
Traffic Mitigation
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
—
EDMOND , WASHINGTON. ITS FFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
W
aii FOR DAMAGES OF OHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
ALL CLAIM
Fire Review
FROM THEISSUA CE OF THIS PERIATT ISSUANCE OF THIS PERMIT $HALL NOT BE
DEEMED TO MODIFY, WA VE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
o NOVI LIMIT IN ANY WAY THE C TYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
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I HEREBY 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
T14E OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
TIOW AND IN DOING THE WORK AUTHORP!E. T.E.EVN. 1ET1. . WILL BE ..PLO1E.
CALL
IN VIOLATION OF THE _ OF 'HE STATE , WASHINGTON RELATING TO
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FOR INSPECTI(
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to N B
WORKMEN'S COMPENSA;PITINSU N E AND ROW 18.27,
SiGNAT (0 ER AGE ATE Sir NED
(425)
/- -2 -Z - 45
771-0220
&FE!kTION
EX"r 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
total
FAX
V — Ift a
E Description FEE
Recording Fee
City Surcharge
State Surcharge
Plan Chk Deposit
Receipt #
us
Receipt # 19MT -x
This application, is net a bourn until signed by the
Building Ofirclad or his/her Deputy: and Fees ale paid, and
recputo Is ack—Adood In seem p—ided.
DATE
1 &-3/ '3 Z_4
ORIGINAL - FILE YELLOW - INSPECTOR
PINK - OWNER GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing . ......................
wall............ .............
Pief/porch ............
Retaining Wall ...........
M
J
Slab Insulation ..........
PLUMBING
Underground .............
C
M
Rough -in ................ . .
Commercial Final
M
M
HEATING;
z
iest;
Gas
Gas Piping.
Equipment ..............
0 _71
Commercial Final
In IT!
a
EXTERIOR SHEATHING
0
0
NAILING ................
ca
MS
0)
M
FRAMING ...................
FIRST FLOOR FRAMING
INSULATION ... .............
Floor Insulation
z
Wall Insulation ...........
Ceiling Insulation
z
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY
Z
..................