20020131.pdf11
D E RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PROPERTY TAX ACOOUNT PAR N COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOAD
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NEW RESIDENTIAL LOT COVERAGE REQUIRED SETBACK$ (FT) PROPOSED SETBACKS (FT.)
PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE BEAR
ADDITION
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CHANGE OF USE
PARKING
REMODEL [3 APARTMENT SIGN EaD PROVI
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REPAIR GRADING CYDS FENCE
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CHECKED �UCTION ICODE
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-T E UNITS REQUIRED [:] YES JAIEA ILOAD
DESCRIBE WORK TO BE DONE REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REOD
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VALUATION
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK
BE DONE ON PRIVATE PROPERTY ONLir. ANY CONSTRUCTION ON THS PUBLIC
Grading
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0
3 OMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MMQUEES, Etc.) WILL REQUIRE
ITO
SEPARATE PERMISSION.
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ngr. Review
PERMIT APPLICATION: 180 DAYS
PERMIT Marc I V.. PROVID D WORK 15 STARTED WITHIN 1811DAYS
Engr. Inspection
SEC BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
, TY
IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND 1GFNT1 "I'M ANIAND
Fire Review
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DISECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT $HALL NOT BE
DEEMED TO MODIFY,
Fire Inspection
WA E OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapelrep.
I HEREBY ACKNOWLEDGE THAT I HAVE REM THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT.' AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
Ini AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
CALL
IN VIOLATION OF THE LA80A CODE OF THE STATE OF WASHINGTON RELATING TO
FORINSPEC
WORKMEN'S COMPENSATR)j�lN�URANCE AND RCW 18,27.
SIGRI
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AWYENTION
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTH
, . "'.. me . ..T..i
A FINAL INSPECTION HAS BEEN MADE AND7VAL OR A CERTIFI-
APPRO
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
10/01
FAX
Recording Fee
City Surcharge
State Surcharge
Plan Chk Deposit
Receipt #
Total Amount Due
Receipt #
APPLICATION APPROVAI
Thu Appliestimi 1, not a permit until signed by Line
Building Offinind " melhm D.p. y: red F .. empiud—d
en.1p, P-Riod.
IFICIALS S:7URE. DATE
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall ............
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Pier/Porch ............
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Retaining Wall
Slab Insulation
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Underground ............
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Rough -in ...................
Commercial Final
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HEATING:
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Gas Test .................
Gas Piping ............
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Equipment ..............
M M
Commercial Final
n
5 F
EXTERIOR SHEATHING
C
NAILING ..........................
M 0
FRAMING ........................
FIRST FLOOR FRAMING
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INSULATION ..........
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Floor Insulation
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Wall Insulation ...........
DO
Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................
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