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[PERMIT EXPIRES 1222
USE
CITY OF EDMONDS ZONE PERM T
NUMBER",-2
CONSTRUCTION PERMIT APPLICATION Joe UITEIAPT#
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OWNER NAMEINAME OF allSINESS _ 52 �'49
Rob,,l� L. PLAT NAMEISUBDIVISION NO. LOT No LI NO.
MAILING ADDREISS I Lt. FEE I
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FIRE REVIEWED BY
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ADDITION
0 COMMERCIAL
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CHANGE OF USE
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APARTMENT
SIGN
PARKING
REO'D I PROVIDED
LOT AREA
I PLANNING REVIEWED BY DATE
REPAIR GRADING CYDS o FE CE
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REMARKS
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RENEWAL
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
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LOAOPANT
DESCRIBE WORK TO BEGONE
R19MARKS
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PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REQ'O
NJ VALUATION
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LOT ELOPE
Building
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Plumbing
PLAN CHECK NO:
ADATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOT -THIS PERMIT COVERS WORK TO
...I INUD.,
t: BEDONEONPRIVATE PROPERTV ONLY.ANYCONSM CmONONTHEPUOUC
Grading
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DOMAIN (CURBS,SIDEWALKS,D C) WILL REdRR.E
RATE PERM;SSIONL E
SERA RIVEWAYS MAROU ES. ETC.) WILL REQUIRE
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ngr. Review
PE MITAPPLICATION: INDAYS
PERMIT UMm I YEAR - PROVIDED WORK IS STARTED WITHIN 10 DAYS
Engy. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS�ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HO D HARMLESS I HE — I OF
Traffic Mitigation
EDMONDS, WAIHINGTON, ITS OFF111111, EMPLOYEES, AND AGENTS 1101, ANYAND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Review
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF
Fire Inspection
ANY CITY ORDINAN E
0 NOR LIMIT IN ANY WAY THE C"S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapainsp.
I HEREBY ACKNOWLE BE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CO RECT. AND THAT I AM THE OWNER, 0, THE DULY UTHORIZED AGENT OF
THE OWNER, I AGREE TO COMPLY WITH CITY AND $TAT LAWS REGULATING CONSTRUC'
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECT14
WORKMENS C
'�MPENSATION 11 SURANCE AND RCW 18.27.
SIGNATURE OWN R A NT) DATE SIGNED
(425)
. r- - " w-
771-0220
ATTENTION/�
EXT 1333
IT IS UNLAWFUL �"SE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
— ON S BEEN MADE AND APPROVAL OR A CEFITIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
Recording Fee
City Surcharge
State Surcharge
Plan Chk Deposit
Receipt #
Total Amount Due
Receipt #_
APPLICATION APPROVAI
ns appil cation Is not a p—it-fil signed by Me
ig Offic�al,, his/he, Depaty: and Fees are paid, and
1.bepn is asinn—Werred 1. space plaYid.d.
LS SIGNATJJRE DATE
ORIGINAL - FILE YELLOW - INSPECTOR
PINK - OWNER GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACK$ ............
FOUNDATION:
Footing ................ . ....
wall..........................
Pier/Porch .................
'j'' Retaining Wall ...........
C)
Stab Insulation
PLUMBING:
-n
Underground .............
Rough -In ............ . ..
M
80,
Commercial Final
-4-
3:
HEATING:
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Gas Test ....................
Gal Piping
Equipment .................
Commercial Final
M M,
EXTERIOR SHEATHING
0
NAILING ..........................
0
0
FRAMING ........................
C
U)
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
z
Wall Insulation ...........
Ceiling Insulation
z
SHEETROCK NAILING
0
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .............
6 off0000