20020067.pdf4* DATE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
=E OF BUSINESS
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PLAT NAMEISUBDIVINDN NO.
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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PAV REQUIRED
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REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROiI.MINA.E
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FIRE REVIEWED BY DATE
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XPIRATION DATE
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REVIEW
COM PLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
FARCE
'ROPER74 L NO.
EXP I
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,
0 NEW
0 RESIDENTIAL
0 PLUMBING I MECH
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SMACKS (FT.)
FRONT SIDE REAR
PROPOSED SETBACKS (Fr.
FRONT L/FISIDE HEAR)
0 ADDITION
0 COMMERCIAL
o C MPLIANCE OR
CHANGE OF USE
PARKING
ReaD I PROVIDED
0 REMODEL APARTMENT 0 SI.N
0 REPAIR
0 1 NCI
0 GRADING CYDS I — X
REMARKS LIT C,I+AP6F-
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0 DEMOLISH
0 TANK
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0 GARAGE
0 RETAINING WALL
0 RENEWAL
CARPORT
ROOKERY
(TYPE ivrry) EXPLAIN:
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GROUP
NUMBER -
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NUMBER OF —I
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UNITS
1 NUMBER
LOAD
DESCRIBE WORK TO BE DONE
RE RKS
'-'GRESS INSPECTIONS PER USC 108/FINAL INSPECTION REOD
Description
FEE
Description
FEE
Plan Check
HEAT SOURCE LOT SLOPE %
AOATE
Building
157'
PLAN CHECK NO: VESTED
"uBR"-g
Mechanical I
b4VI— b
THIS PERMIT AUTHORIZES ONLY THE ORKNOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
—
Grading
Recording Fee
DOMAIN (CUABS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATEPERMISSION.
Engr. Review
City Surcharge
PERMITAPPLICATION: ISDDAYS
PERM911111 I YEAR -PROVIDED WORK IS STARTED WITHIN I.DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT MR MORE INFORMATION
*APPLICANT ON "EHM.F OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. A.11EIS TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY (11
'DMONGS' WASHINGTON. IT$ OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt III,
ALL CLAIMS FOR DAMAGES OF WHATEVE NATURE ARISING DIRECTLY OR INDIRECTLY
R
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCi OF THIS PERMIT SHALL NOT HE
DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF My CITY ORDINANCE
Fire Inspection
TotalAmountOue A
0. NOR UNIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
L ndscapelnsp.1
Receipt #
I HEA91Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIOW THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT� AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I RES TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC,
CALL
This appli.rifl.. 1. net. p—Ittettil signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE BE OF THE STAT OF WASHINGTON RELATING TO
Bufldi,g Offidal or blather Deputy: and Fees are paid, and
FOR INSPECTION ree.1pli�.�k�..I.dg.di.�p..�p,o�id.d.
WqwAtmm-CqMPENSA7. �I&OWNCE AND CW 1.21.
OFF) S I DATE
I ATU7
E SIGNED
(425)
.7.
/2
771-0220
e BE
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
.,,161 F E YEIU�W - IIN6PE OR
LLN�� W'
. NEa GOLD - ASSESSOR
10/01
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ...............
FOUNDATION:
Footing ......................
wait ...................
Pier/Porch .................
Retaining Wall ...........
Stab Insulation
PLUMBING:
Underground .............
0 M
Rough -in ...................
M
0
C)
�0
Commercial Final
—4
X M
HEATING:
ITI
Ga. Test .............
Gas Piping ..............
Equipment , ................
Commercial Final
M M
EXTERIOR SHEATHING
NAILING ..........................
0 R�
FRAMING ................
Q 0,
FIRST FLOOR FRAMING
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INSULATION ................
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Floor Insulation
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Wall Insulation
Ceiling Insulation
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