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PERMIT EXP
PERMIT
US
CITY OF EDMONDS ZONE NUMBER _4)
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CONSTRUCTION PERMIT APPUCATION JOB SUITEIAPT#
ADDRESS
OWNP 1IAA1EZM1 OF-65SINESS ! ,.,
JD NO.
MAILING ADDRESS 10 FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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C�TYS III NI 1111T 11 — P1111111— I`-
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NAME METER SIZE I LINE I PRV REQUIRED
YES C3 NO 13
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R [.E.IC..RAC.N RE.P.NSME Fee EROSION ..NTR.LRN1AI-AGE
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FIRE DATE
CITY ZIP TE1111IONE
1Y
VARIANCE OR CU SHORELINE OR ADS# IN
13'
LiEL
PROPERTY TAX CCO PARC CON SEPA REVIEW 9iGN AREA HEIGHT
PLETE EMMPT ALLOWED PROPOSED ALLOWED PROPOSED
,
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0 NEW RESIDENTIAL REQUIRED SETB.KS 11T) PROPOSED SETBACKS tFT)
PLU.11111. I NRECH A11GWEDC PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR
0 ADDITION 0 COMACERCIAL o COMPLIANCE OR
CHANGE OF USE
PARKING LOT AREA P NINO REVIEWED 8 DATE
0 REMODEL 0 APARTMENT 0 SIGN REGO I PROVIDED
0 REPAIR 0 GRADING GYGS 0 FENCE
I X FT, RIMARKZ4=6j2��
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0 DEMOLISH 0 TANK 0 OTHER I
oGARAGE 0 RETAINING WALL
CARPORT SOMIRY 0 RENEWAL
FYPE OF USE. BUSINESS OR IN:
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< CHECKED By J=CTION CCUIANTX:�
OF I CRITICAL
G AREAS IVI NT
_ S ECIAL INSPE(
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OSTO.. I
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UNITS NUMBER REQUIRED 0
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER USC 110811FINAL INSPECTION REaD
e16 A,�o
q000 t, wly)(
V ALUATION $
V. Descirlieflon FEE DeSeflption FEE
PLAN CHECK NO: VISTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE IND KNOTED. THIS PERMIT COVERS WORK TO
t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION OUT EPU LIC
H a
Grading
Recording Fee
DOMAIN (CURSS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION` IWDAYS
Engr. Review
City Surcharge
PERMIT LIMIR I YEAR - PROVIDED ORKISSTARTEDWITMN IGODAYS
Engr. Inspection
State Surcharge
SEE ,ex OF PINK PERMIT Fort MORE INFORMATION
'APPUCAW, ON BEHALF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTERESX ASSESS INDEMNIFY, DEFEND AND HOLD HARML SS THE CITY OF
I EDMONDS' WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
T
ALLCLAIMS FOR DANA ES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE 01 THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE On REDUCE ANY REOUIREMENT OF MY CITY ORDINANCE
Fire Inspection
Total Amount Due
NOR LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE A Y ORDINANCE PROVISION.-
Lrmdscapelnsp.
Receipt #
I HERE- ACINOWLIDGE TH E READ THIS APPLICATION; THAT THE INFORMATION
AT 1 1"4AVTHE
APPLICATION APPROVAL
GIVEN IS CORRECT, AND T "AT OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTPIUC-
CALL
This '0'ffid.le,
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LA;I.INWDE.OF THE ST E OF WASHINGTON RELATING TO
FOR INSPECTION
Bulm.g tre.1her Carey wd Fees am paid. 6
—cept is..knal.dged In space proAded.
.,.Ip,i
WOAKMEN'S COMPENSAT) CE _. RDW IS
OF rl S S G DATE
'NATU E
DATE 110's.
(425)
�EA..D �.Yl
771-0220
RI
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, USC SECTION 109
FAX
PINK - OWNER GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ..............
FOUNDATION:
Footbig ..........
wait................ . ........
Pier/Porch ...............
z
Retalnlng Wall
Slab Insulation
PLUMBING:
Underground .............
Fft -4
Rough -in ...................
M
0
Commercial Final
0
C
HEATING:
M
11711 z
GasTest ..............
0-.4
Gas Piping ............
_X
Equipment .................
Commercial Final
0 -n
PD
E)(TERIOA SHEATHING
ITI 1111
NAILING .....................
FRAMING ...............
FIRST FLOOR FRAMING
M
INSULATION ...................
Floor Insulation
Wall Insulation ; ..........
Z
Ceiling Insulation
SHEETROCK NAILING
Z
SPECIAL INSPECTION
0
ITI
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY .............. . .. ................