20020074.pdfATE RECEIVED
[PERMIT
EXPIRES
USE PERM T
ZONE
CITY OF EDMONDS
UMBER
CONSTRUCTION PERMIT APPLICATION SUITE/APT#
ADDRESS
VINES �.A.Elf..E.F BUSINESS
mel5";wv PLAT NAMEISUBDIVISION NO LOT 401 LID NO.
LID FEE S
&LA�_ RIGHT OF WAY FEA 11110AL STREET MAP
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VIZIP TELEPHONE EXISTING— PHOPOSED— 11,01, 11 Rkod
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REQUIRED DEDICATION— FT —
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NAME METER SIZE
LINE SIZE
I NO. OF IX1uRES
PRV REQUIRED
YES 13 NO 0
...... REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
ZIP
JTILEIHONI
NAME
WO(Z-o4iNP 110vorz. H' 14 f 1 �57
ENGINEERING REVIEWEDIDATE
M ADDRESS
1-70 LE &Ak N 91
FIRE REVIEWED By DATE
CITY
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STATE LICENSE NUMBER EXPIRATION VARIANCE OR CU SHORELINE OR ADS# INSPECTION
IPSONO
RE OSTED
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PROPERTY TAX ACCOUNT PARCEL NO. C SEPA REVIEW SIGN AREA HEIGHT
OMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
EXP
171 NEW Q:�RESIDENTIAL LUNGING MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
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0 ADDITION 0 COMMERCIAL C MPUAN E OR
0 CHANGE OF USE �j
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0 DEMOLISH 0 TANK o OTHER
o GARAGE RETAINING WALL
CARPORT DOCKERY 0 RENEWAL
(TYPE OF USE. BUSIN! TY) "PLAIN:
CHECKED BY
GROUP
NUMBER OF CRITICAL
CRITICAL
tREMARKS
JPFA,�WN �COCACGUPAX,5
DWELLING A SAS SPECIAL INSPI To AREA OCCUPANT
0 NUMBER REQUIRED
UNITS YES Lo
DESCRIBE WORK TO BE DONE
PROGRESS INSPECTIONS PER U.0 110811I.Al. INSPECTION REGrO
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Description FEE Description FEE
Plan Check
HEAT SOURCE BLAZING I
'Or SLOPE Building
Plumbing
PLAN CHECK NO:
THIS PERMIT AUTHORIZIES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical . ......
1: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCID Grading
2 ONONTHEPUBLIC
:I ONLAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, arc.) WILL REQUIRE
.... . ..
Recording Fee
1: SEPARATE PERMISSION.
a — Engd. Review
FAR - PROVI ISO DAYS
PERNRTLJMMiY RE "FT APPEUDCWATOJORKN]SloSDTADRATYESO WITHIN Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
City Surcharge
State Surcharge
Plan Chk Deposit
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Review
ALL CLAMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUA CE OF 0111 PERMIT ISSUANCE OF THIS PERMIT SHAUL NOT BE Fire Inspection
DEEMED TO MODIFY, WAIVE OR REDUCE ANY EQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Receipt #
Total Amount Due
R...,pt #
Landscapoinsp.1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATI THAT THE INFORMATION — I I I
ON; APPLICATION A '
GIVEN IS CORRECT. AND THAT I AM THE OWNER OR THE DULY AUTHOR ZED AGENT OF PIPROVt
THE OWNER . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC, CALL Thl, ""I ""' " nod by do,
" &`Fuly. and F..' P IdL,
TION; AND IN DOING THE WO K AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED d1h,g o1o.1'
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION —.1 ..... ro.ld.d.
WOAKMENA,COMPENSA1r$"SURANCE AND TIC 18.27. OF �LCALS �SIGNATUE DATE
DATE SIGNED (425)
I - I _0 RE �EASEG 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
CATE OF OCCUPANCY HAS BEEN GRANTED. ORIGINAL, - FILE YELLOW , INSPECTO
UBC SECTION 109 FAX PINK - OWNER - GOIG�ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...........
FOUNDATION:
Footing ...............
wall.....................
Pier/Porch .............
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Retaining Wall ...........
Slab Insulation ..........
PLUMBING
Und URd
. . . . ..... . ..
M
0
Commairclaff1hal
0
HEAT
M
Z
Gas Test ....................
Gas Piping ............
>
Equipment ................
"n
Commercial Final
M
EXTERIOR SHEATHING
M
a
NAILING ..........................
0
A
FRAMING ........................
0 M
C fl)
ca
FIRST FLOOR FRAMING
M 0
Z F—
INSULATION — ................
Floor Insulation
z
Wall Insulation ...........
Ceiling Insulation
z
SHEETROCK NAILING
0
—I
SPECIAL INSPECTION
0
M
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY .................. ............