20020100.pdfDATE RECEIVED
PERMITEXPIRES
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UZOSNE PERMIT
CITY OF EDMONDS NUMBERI;��Z��_
CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT#
ADDRESS
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FLAT NAMEISUBDIVISION NO, LOT NO, LOAD.
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP IS- mu."'e'
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REQUIRED DEDICATION— 17 Ud
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NAME METER SIZE I LINE 111E I NO-011-UREI 11V REQUIRED
ADDRESS BEMA... 3 , YES 0 NO
OVYINERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIUMINAGE
CITY ZIP IT11111ION'
NAME I —
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FINE REVIEWED BY DATE
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PROPERTY TAX ACCOUNT PAI
SEPA REVIEW
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SIGN AREA
ALLOWED '"010111
HEIGHT
ALLOWED PROPOSED
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LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT)
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ALLOWED PROPOSED
FRONT SIDE REAR
IT
ADDITION 'J?rCOMMERCIAL C MILIANCE OR
CHANGE OF USE
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REMARKS
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GARAGE ETAMIN WALL
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(TYP S OR ACTIVITY) EXPLAIN:
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NUMBER
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LOAD
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DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER USC JoelFINAL INSPECTION FlEaD
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Description
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FEE
Description
FEE
Plan Check
LOT SLOPE %
LAN,
Building
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NO: .STED DATE
'Run I
P1 urnbing
0
=CK
IT!
THIS PERMIT AUTHORIZES ONLY THE WO KNOTED. THIS PERMIT COVERS WORK TO
Mechanical
OR DONE ON PRIVATE PR ONLXANYCONSTR CTIONONTHEPUBLIC
OPENTY
Ft
Grading
Recording Fee
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION,
Engr. Review
City Surcharge 6—
PENUMAPPLICATION: INDAYS
PERMIT LIMIT, I YEM. PROVID D WORK IS STARTED WITHIN IGODAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICA ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREWS-T, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Receipt #
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS Fort OAMAGES OF WHATEVE NATUREABISIN..IRECTLYOR INDIRECTLY
Fire Review
FROM THE ISSUANCE OF THIS PERMIT." ISSUANC� OF THIS PERMIT SHALL NOT BE
OF ANY CITY
Fire inspection
TotalArnounlD a
1
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT ORDINANCE
0 NOR LIMIT IN ANY WAY THIS CITYS ABILITY TO ENFORCE ANY ORDINANCE PHQVISION�
x
Landscapainsp.
Receipt #
I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT TH INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
STRUC
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CON -
CALL
1, led by me
Th S appligatio, IS net a permit urell Sig.
D THE WOK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOY",
AND"'n IWA H.GTO ELATINGTO
L.'0VN1j-T LAB�Ctn CODE 01 THE STATE B I N
Bull di.gOfli�I.I.,hl�th.,D.P.ty:�ndF.. empirld,mid
FOR INSPECTION eeteru 1. SSkn..I.dg.d luirp .. provided.
SIG. MERE! AT., INSURANCE AND RCW 18,27.
0 CA LS TUR DATE
SIG"Rk Wk R AGEIn4) DATE SIGNED
(425)
771-0220
,
BY DATE
ATTENTION
Off 1333 7E
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 - FILE YELLOW - INSPECIQH
CATE OF OCCUPANCY HAS B :EN GRANTED. LEG SECTION 109
r
FAX
PINK - OWNER - GOLD - ASSESSOR
Wier /
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall.................
Pier/Porch .... ............
z
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground ...........
M
Rough -in ................
Commercial Final
HEATING:
0 C
Test
ITI
Gas ....................
10
Gas Piping .................
ra
Equipment .................
0
Commercial Final
EXTERIOR SHEATHING
M M
NAILING..........................
0
0 Fn
FRAMING ........................
FIRST FLOOR FRAMING...
k C'S
0
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
z
SPECIAL INSPECTION
M
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..............