20020093.pdf-I
DATE RECEIVEG,�
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PERMIT EXPIRES
CITY OF EDMOZS ZU01". PERM T
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CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT#
ADDRESS
MYEIN�41E OF
qUSINESS
APLAT NAME/SUBDIVISION NO. LID 10.
7
MAILING ADDRESS LID FEE S
PUBLIC RIGHT OF WAY PER OPTIMAL STREET GAP
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CITY EXISTING
- PROPOSED -
REQUIRED DEDICATION- FT
NAME METER SIZE I
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YEPRVAEQUIREO
SO NO 0
A.341!ga� REMARKS
CWNEFVCONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDMINAGE
CITY
NAmisHAL
NAME
Co PRESENT FU
NGINEERING
ADDRESS
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FIRE REVIEWED BY DATE
CITY ZIP TELEPHO I
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VARIANCE OR CU SHORELINE OR ADB# INS BOND
STATE LICENSE NUMBER EXPIRATIC 'ECTION
;PE 'D POSTED
co C 13YES [3NO
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SEPA REVIEW SIGN AREA HEIGHT
ACCOUNT DEL NO� COMPLETE E EMPT ALLOWED PROPOSED ALLOWED PROPOSED
PRO;7
EXP ,
W I LOT COVERAGE REQUIRE SETBA KS (FT. PROPOSED ETBACKS (FT.)
11 HE RESIDENTIAL PLUMBING I MECH ALLOWED PROPOSED FRONT D SIDE C HEAR I FRONT USA SIDE REMI
1:1 ADDITION COMMERCIAL 0 COMPUA CE OR
CHANGE OF USE
0 REMODEL 0 APARTMENT 0 SIGN IEA] PLANNING R-1-10 BY DATE
REPAIR GRADING F NCE
CYDS _X-Fr) REMARKS
DEMOLISH =TAN OTHER
0 GARAGE R NING WALL
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ARPORT ROOKERY RENEWAL
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(TYPE PF USE, SUSIN�ESS OR ACTAI EXPI
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- LING SPECIAL INSPE 'To, AREA tu NT
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L , NUMBER REQUIRED 0 , S D
DESCRIBE WORK TO BE DONE
p 3iV REMARKS
PROGRESS INSPECTIONS PER UBC 108/1FINAL INSPECTION REO'D
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FEE
Plan Check
HEAT SOURCE LOT SLOPE %
PLAN CHECK NO: TED DATE
Mechanical
IC THIS PERMIT AUTHORIZES ONLV THE WORK NOTED. THIS PEFUGM COVERS WORK To
HE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUDUr
G OMOUN
Grading
Recording Fee
(CURBS, SIJEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL BEGIN RE
SEPARATEPERM;SSION.
Engr. Review
City Surcharge
PERMIT Login I RE MITAPPUCATION., 140DAYS
YFAR-PROVID D WORK ISSTAFITIZO WITHIN ISODAYS
En9r. Inspection
State Surcharge
BACK OF PINK PERMIT FOR MORE INFORMATION
—PILOASIT ON BEHALF 011111 OR HER SPOUSE. HEIRI. ASMONS AND SUCCISORS
Traffic Mitigation
I
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFN, DEFEND AND HOLD HARMLESS THE CITY OF
ID1101111, WASHINGTON, ITS OFFICIALS, EMPLOYEES. -- AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE I SUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODtFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
Total Amount Due
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscape Insp.
Receipt #
I HERSINY ACKNOWLEDGE THAT HAVE READ IS APPLICATION; THAT THE INFORMATION
TH
GIVE" IS CORRECT. AND THAT AM THE OW R, OR THE DULY AUTHORIZED AGENT OF
I
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTfIUC.
AND
CALL
This application Is not a permit tudd signed by the
TION; IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE L OF THE STAT OF WASHINGTON RELATING TO
FOR INSPECTION
Sultaing Official a, his1hor Deputy: and Fees are paid, and
WORIMI�MICOMPENSAT;XSOCEN.S AN. . .
(425)
DATE
9--
771-0220
L'?Eh
R'L
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 CERTiFl-
771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
ORIGINAL -FILE - YELLOW -INSPECTOR
PINK -OWNER - GOLD
10101
-ASSESSOR
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FINAL PR6JECf APiR&AL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FIRE DEPARTMENT DATE
FROM:
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE —
PROJECT ZJU(--6fZ10
SITEADDRESS 2=1q43
PERMIT 0�0'7.ADB#__DATE INSPECTED_2_—_LL—_j2-2_-
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine compliance with -approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
_PERFORNL4NCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copyof CONDITIONS given to owner/contractorby inspector 80,964,r
A, Due -
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE -given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1Jemp:b1dg:fonns:ocapn,1 3/25/04
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .................
FOUNDATION:
Fooling ...................
wall, ...............
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Pler/Porch ................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
M
Underground .............
C
M Q
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Rough -in ...................
0
Commercial Final
ID
trill
HEATING:
Gas Test ....................
C4
Gas Piping .............
Equipment .; ...............
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Commercial Final
M M
EXTERIOR SHEATHING
NAILING ..........................
C 0)
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FRAMING ........................
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Z
FIRST FLOOR FRAMING...
INSULATION ...............
Floor Insulation
z
Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
IT
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAtFIDR-,
OCOJILPA"y ............. ...
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