20020127.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
CITY ZIP TELEPHONE
NAME Type B or L Vent connectors
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FLAT NAMEISUBDIVISION NO
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EXISTING — PROPOSED
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METER SIZE
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NO. OF FIXTURES
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PROPERTY TAX ACCOUNT PARCEL No.
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NEW ... KIENTIAL A' OVE a PROPOSED SETBACW5 (FT.1
LL,460VVII REQUIRED SETBACKS IFT
LL F '0 FRONT Sloe BEAR FRONT LIRSIDE HEAR
0 ADDITION COMMERCIAL
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[AREA OCCU NT
STORIES UNITS
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LOAD
DESCRIBE WORK DONE
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VALUATION
PLAN CHECK NO:
VESTED DATE
Plumbing
Mechanical
THIS PEAMPT AUTHORIZES ONLYTHE WORK NOTED. THIS PERMIT COVERS WORK TO
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3
8 DONE ON PRIVATE PROPER" ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
3
DOUJUH (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
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SEPARATE PERMISSION.
Engr. Review
PERMITAPPLICAR N: 180DAYS
PERMIT LIMIT. I VISA,, -PAOV"` 0 WORK IS STARTED WITHIN ISODAYS
Engr. In!!!!!j!j
SEC BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON SERIAL OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONOS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS MO. A. AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING 0 RECTLY OR INDIR CTLY
Fire Review
FROM THE ISSUANCE OF THIS PERMM ISSUANCE OF THI 11MIT IIIALL NOT BE
SEEMED TO ...I- -WE OF RE ... E -1 .110.1REMENTSOF ANY CITY ORDINANCE
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NOR LIMIT IN ANY WAY THE CHYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
rINSPECTII
GIVEN IS CORRECT AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNEIL TAGRE TO COMPLY WITH CITY AND STATE LAWS REGULAI ING CONSTRUC.
TION; AND IN DING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
IN VIOLATION OF THE "BOB ODE OF THE STATE OF WASHINGTON RELATING TO
FOR
:S COMPENSAHr�WNCE AND �CW 18,27.
IDWNER 0 If DATE 1
(425)
42L
771-0220
ATTENTION
Off 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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
10/01
FAX
�,�,an lanKs are I
FEE
Recording Fee
City Surcharge
State Surcharge
Plan Chk Deposit
Receipt #
TotalAmountDuo
Receipt #
ICATION APPROVAL
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or h1afher Deptay: and Free are Palo, and
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RELEASED .1
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ORIGINAL -FILE YELLOW � INSPECTOR
PINK -OWNER GOLD -ASSESSOR
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MEMORANDUM
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Date: February 21, 2002
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To: Beth Duvall, Accounting Assistant
From: Marie Harrison
Subject: REFUND
A,
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01
-40
Beth, please prepare a refund check in the amount of $55.00. Uniform Building Code Section
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107.6 Fee Refunds. The Building Official may authorize refunding ofnot more than 80 percent
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of the permit fee paid when no work has be done under a permit issued in accordance with this
code. The permit #2002-0127 was issued February 14, 2002. The permit w as issued in error, it
is a duplicate permit. Please mail the check to Blue Dot Services Company o fWA, Permitting
Services, I"Avenue#250, Seattle, WA98121. I have enclosed a copy of our receipt #18956 for
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your records. Thank you.
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Sincerely,
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WaA;'Riiiison
Development Services Division
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City of Edmonds cze Community Services
RECORD OF INSPECTIONS
INSPECTOR� 76AtE 000OVED�
SETBACKS ................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch ................. .
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Retaining Wall
0
Slab Insulation ..........
F1
PLUMBING:
Underground .............
3:
0 M
M 0
Rough -in .� .................
0
-10
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Commercial Final
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H1*TING:.,_,
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Gas Test
C: 2
Gas Piping ........ ..
Equipment .................
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-4
Commercial Final
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EXTERIOR SHEATHING
NAILING .. ........... ............
6
FRAMING ........................
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FIRST FLOOR FRAMING...
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INSULATION ...................
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
0
SPECIAL INSPECTION
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