20020090.pdfIPERMIT EXPIRES I L 1. G I
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CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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NAME
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VARIANCE
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LOT AREA PLANNING REVIEWED By DATE
0 REMODEL
APARTMENT
0 G
SIGN RE 0 1 PRO IDED
REPAIR
GRADING CYOS
[:, FENCE
I — X FT) REMARKS
0 DEMOLISH
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NUMBER
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NUMBER
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DESCRIBE WORK TO BE DONE
RE MARKS
UBC 10S/FINAL INSPECTION REITI
PROGRESS INSPECTIONS
PER
15A�
1,�A-<
LEI
VALUATION $
Description
FEE T7FEE
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LOT SLOPE %
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VESTED DAT'E
Numbing
Mechanical
RK�OTJEO -On' W09KTO
PERMIT AUTMR ONLY . UBUC
PROIE=WO CTIONONTHESPOUIRE
earrachng
E DONE ON PRIVATE
Do"N (CURSS, SIDEWALKS. DRhNEVfAYU, ETC,) WILL RE
SEPARATE PERMISSION-
Engr. Review
pB,MffA,pUCATIOH: HKIDAYS
PEPMFT UMM. I YEAR - PROVIDED WORK IS STARTED WITHIN ISODAYS
Engr. Inspection
SIBE BACKOF P5W PERMIT MR MORE INFORMATION
-APPLICANT. ON BEHALF OF HIS 0. HER SPOUSE. HEI&,ASSIGNS AND SUCCESORS
io HARMLESS THE CITY OF
Fy FEND H.
Traffic Mitigation
IN INTEREST, AGREES TO INDEMN
I ITS opg��E ES AGENT Aw AND
AND
. EM Lo E rS
AND
EDMONDS. WASHINGTON. 'UWHATEVER
a
Fire R view
I NATURE MSINGOIRECnYFROORI NGIRECTLY
CLA' M F MAGES "' ';��i'OF THIS PERMIT SHALL NOT BE
OR;FFYCE PERMIT ISSU
MFG
Fire Inspection
THE! I OF 'IS
OM D To SSU
ME OR REDUCE My REOU'REMENT OF
DEEME M D W ORANY CITY ORDINANCE '
DINAkNNCE PROVISION'
NOR LI MTTN 0 Y Wky THE CnyS AS, LrTY To ENFORCE ANY
A
LandscapaInsp.
WN, 0 THE L�THAT HE INFORMATION
I HERESY ACKNOWLEDGE =T UN
� HAVTERff -IR APPLICATIO AUTHORIZED AGENT OF
T AM
GIv'N WS REGULATING CONSTRUC
0 MpLy WITH CITY AND STATE LA
CALL
THE
T'..; "EGyQNO PERSO WILL BE EMPLOYED
RK=O1'1Z,1&`Gu` E F WASHINGTON RELATING TO
TAT
FOR INSPECTION
IN V R
WORKMENS COMPENSATI��UAANCE AND RCW 18 27.
(425)
SIGNATURE (OWNER AGENT)
771-0220
EXT 1333
ATTENTION'
IT IS UNLAWFUL TO USE 08 OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIF1
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
'BID'
FAX
C d g Fee
o 'g
C.", s.harge
State Surcharge
PiarT Chk Deposit
Receipt III
Total Amount ouq(�
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
BE' :TSACKS .....................
FOUNDATION:
Footing ......................
wall..........................
Pier/Porch .................
Retaining Wall ...........
Stab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
Gas Test ....................
Gas Piping ..............
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Coiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANIECR
FINAL APPROVAL FOR
S_
OCCUPANCY ..................
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ADD;RES�S
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CITY zu,
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REQUIRED D DICATION— FT —
-
METER SIZE
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REMARKS-1— REs
—1— - PONSIBLE FOR EROSWN CONTROUDRAMAGE
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NT MOCKERY E] RENEWAL
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FRONT SIDE REAR
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FAWING
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LOT
I PROVIDE
AREA
PLANNING REVIEWED By DATE
MNIARKS
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DESCRIBE WORK TO BE DON'
REMARKS
PROGRESS INSPECTIONS PER USC 108)FINAL INtjptu i ium
Description
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FEE
Description I
t-t:t
Plan Check I
SOURCE GLAZUIG % LOT SLOPE %
Building
[."ecghani�l
PLAN CHECK NO: �ITED DATE
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Plumbing
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THISPERMITALITHORIZESOWTHE WORK NOTEO. THIS PER11IT COVERS WORK TO
I: BE DONE M paVATE pROPERay O� ANY CONSTRUCTION ON THE PUBLIC
&.Wq
—ky 65 2�
!zn Recording Fee
2 IRE
3 DOMAIN (CURBS, SIDEWALKS, DRrVEWAYS, MARQUEES, ETC.) WILL REOU
_-
L WARATEPERMISWON.
Engr. Review
City Surcharge
PERWITAPPLICATION' Is' DAYS
PjRNmr UMM I vt� _ PROVIDED WORK IB STARTED wnau. HKI.
Engr. Inspection
StateSurcharge
SEE BACK Of PINK PZR&HT FOR MORE INFORMATION
-APPLICANT. ON MKALF OF HIS OR HER SPOUSE, HEIM. ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
III INTEREST, AGREES TO I .... 111- DEPEND AN. HOLD HARIALE.. THE CITY .1
EDMONDS WASHWarON. 98 OFFICIALS, EMPLOYEE% AND AGENTS FROM ANY AND
Fire Review
Recept #
CLAR,i� FOR DAMAGES OF WHATEVER NATURE. AWS NO DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL- NOT HE
Fire Inspect
Total Amou nt D U
DEEMED TO MODIFY. WANE OR REDUCE ANY RE QUIREMENT OF ANY CITY ORDINANCE
'OR UNIT IN ANY WAY THE rfrft ABILITY TO ENFORCE ANY
Receipt 1,75'
Landscapainsp.
6V
I HERESY ACKNOWLEDGE THAT HAVE READ TH APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT ANDTHAT AM THE OWNER. OR THE DULY AJJTHOR DAGENTOF
�
THEOW'EFL I AGREE TO COMPLYWani CITY AND STATE LAWS REGULATING CON'TRUC.
CALL
U�w .19� by .
TION; AND IN 'NO THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
RELATING TO
FOR INSPECTION
BW D"Lty: wd Res we p&W. a
W edged k,.p— P�!J�
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
WORKMENS C0MPENtTK=CE AND RCW I .27.
OF� UR clt/
AT�71)
(425)
�810
/I
I
1
771-0220
BY DATE
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-FIUE - YELLOW-WSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBG SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
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