20020077A.pdfSAWN DATE RECEIVED,
CIT� OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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ING ADDRESS
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NAME
FPERMIT EXPIRES
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ADDRESS &V,
SUITEIAPT*
PI, LOT No. L
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING - PROPOSED
REQUIRED DEDICATION- FT
METER SIZE I LINE IIZ5 1 10. OF FIXTURES YEIRV REQUIRED
SO NO 0
R MARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
. .. ........ .........
FIRE REVIEW50 BY
DATE
STATE LICENSE NUMBER
VARIANCE 1111011
SHORELINE OR ADII
INSPECTION
RED D
I PBON.0
DST
11PIRATION
DATE
CHICKIII ly
OYES ONO
PROgTY TAX ACCOUNT PARCEL NO '41
6 co
SERA REVIEW
COMPLETE I EXEMPT
EXP
SIGN AREA
ALLOWED I PROPOSED
HEIGHT
ALLOWED PROPOSED
NEW
RESIDENTIAL
SING i MECH
�_�P.Lum-,
LOT COVERAGE REQUIRED SETBACKS (PT)
ALLOWED PROPOSED FRONT SIDE PEAS
PROPOSED SETBACKS IM.
FRONT L/A SIDE REAR
0 ADDITION
COMMERCIAL
ANCE OR
0 CHANGEOrUSE
- - - - - - - -
>(REMODEL
0 APARTMENT
0 SIGN
PARKING
RED D
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PROVIDED
LOT
Iy DATE
0 REPAIR
0 GRADING CYDS
0 FENCE X FT)
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0 DEMOLISH
0 TANK
0 OTHER
0 'APAG
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NUMBER
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REMARKS
1
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'l
A 177 7, -477C, 161 ce 77
PLAN CHECK FEE
CA , na
LDING
E K UED DATE
L= I
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES� ETC.) WILL REQUIRE
GRAOINGIFILL
SEPARATE PEnmisslow.
STATE SURCHARGE
PE MIT APPLICATION; 180 DAYS
PERMIT LIMIT, I YEAR - PROVIDED WORK IS STARTED WITHIN 18D DAYS
EN9-fffV+EO��EFS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
?I
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS ANDSUCcESORS
ENG. INSPECTION FEE
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD I- ....
LANDSCAPING
2 E MONDE WASHINGTON, ITS OFFICI LS� EMPLOYEES. AND AGENTS FROM ANYAND
IF
LNSPECTION FEE
A L CLIMB FOR DAMAGES OF WHATEVER NATURE. ARISING OIRECTLIOR INDIRECTLY
x FIT M THE ISSUANCE OF THIS PERMiT. ISSUANCE OF T141S PERMIT SHALL NOT BE
DEEMED T=IFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
P C
.1 NoRLIMIT WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION
CE'75?Y_gA 'N/,g6z
TOTAL AMOUNT DUE
IR I I
IHEAEB 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
0PCICATION APPROVAL
THE OWNER� I AC.REE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUG
TION� A D N I H ORK AUTHORIZED THEREBY, NO FEITS N WILL BE EMPLOYED
CALL
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dPB, h,,lh�l DIy� F Foes .,o p,.d. ,d
IN VIOL [ON 0 - THE LABO ODE OF THE STATE OF WASHINGTON RELATING 10
FOR INSPECTION
WEFKM SCOMPERSAT IN URANCE
I, NO RCW 19.21,
OFY�IALS 81�NAP DATE
SIGN.
(425)
I 6E
__��ATE
1
771 -0220
PC I'D 6
ATTENTION
EXT 133,
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-
LOW - INSPE TOR
CATE OF OCCUPANCY HAS BEEN GRAN"rEO, UBC SECTION 109
FAX
PINK -OWNER - GOLD ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
wall ...............
Pier/Porch .................
Retaining Wall ...........
Slab Insulation
PLUMBING:
Underground .............
Rough -in ................ s..
Commercial Final
HEATING:
Gas Test ....................
Gas Piping
Equipment.................
Commercial, Final
EXTERIOR SHEATHING
NAILING .......... ...............
FRAMING .. ...............
FIRST FLOOR FRAMING
C'>—
INSULATION ................
Floor Insulation
Wall Insulation ...........
Coiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..............
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