20020157.pdfE RECEIVED-
6' 1 &,-:q I I PERMIT EXPIRES
Lit a/'// I I us PERMIT
CITY OF EDMONDS Z04 NUM BE R
CONSTRUCTION PERMIT APPLICATION JOBEESS SUITEAPTO
ER NAMEINAME OF DUSINE% 11.1to-f OWAA ADD 51.Al
PLAT NAMIUSUDDIVISION NO, LOT NO, LID NO,
20
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ING ADDRESS LIDFEES
L071 Ziloll" G7- PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
NE EXISTING_ PROPOSED— 'd-
13
REQUIRED DEDICATION— FT
3 Vul,K'seuese 13
W.E.C.HT 31.1� ED. E ... 101. ..1,1111.11.11A.AGE
F METER SIZE I LINE SIZE No OF FIXTUEES FEW REQUIRED
YES E3 NO C3 3
apeop- geca, rinza< REMARKS
FACTOR RESPON us
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STATE LICENSE NUMBE EXPIRATION D /5e2 4'�e
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FIRE REVIEWED By
VARIANCE OR CU SHORELINE OR ADD#
$EPA REVIEW SIGN AREA
C MPLETE , EXEMPT ALLOWED PROPOSED
DATE
INSPECTION 7_13—OND
r3y REOD No IPOSTED
ES [3
HEIGHT
ALLOWED PSOPO110
0 RESIDENTIAL LOT C VERAGE REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (I
N EW
0
0 PLUMBING I MECH
ALLOWED PROPOSED FRONT SIDE BEAR
FRONT URSIDE BEAR
M
ADDITION
COMMERCIAL
C MPUANCE OR
0
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1
se
9
se
HOANGE OF USE
PARKING LOT ARE PUNNING REVIEWED
BY DATE
E3a EMODE L
'R APARTMENT
El SIGN
RED, D I PROVIDED
EL REPAIR
GRADING
[3 F NCE
[3 CYDS
X FO
REMARKS
0 DEMOLISH
TANK
13 OTHER
[3 GARAGE
RETAININ WALL
G
ARPORT
[3 FROCKERY
[3 RENEWAL
(TYPE OF USE * BUSINESS OR ACTIVITY) EXPLAIN:
CHECKEDBY
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ITYPEUNSTRUCTION
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NUMBER
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UMBER F
DWELLING
CRITICAL
AREAS
SPECIAL INSPECTOR
OCCUPANT
STORIES
UNITS
NUMBER
E LRED JAREA
R 13 YES
LOAD
DESCRIBE WORK to BR'DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
0
VAWATION $ (,4 11,
Descirbotion I FEE
HbA
_�� I
I LOT SLOPE %
Building
PLAN CHECK NO:
VESTED DATE
Plumbing
I
Mechanical
THIS PERMIT AUTHORIZES ONLY THE ORK NOTED. THIS PERMIT COVERS WORK TO
t "111"11"111EPIIPEI*IIAIINIUIII"1"1111IIC
Grading
Recording Fee
IDIIIUUM JCURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, Into.) WILL REQUIRE
SEPARATEPERMISSION.
Engr. Review
City Surcharge
PERMIT APPUCATION: IN DAYS
PERMIT UMIM I YEAR � PROVID WORK IS STARTED WITHIN ISODAYS
Inspection
state Surcharge
4�
SEE BACK OF PINK PERMIT FOR MORE INFO MATION
'APPLICANT, ON BEHALF OF HIS OR HER $POUSE. HEIM, ASSIGNS AND SUCCESORS
Traffic
Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHIN N, ITS OFFICALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
L CLAIMS FOR DAM'21 OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
'IF BE
[Engr,
gMitigation
FROM THE ISSUANCE THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT
DEEMED TO MODIFY. WAIVE OR RED CE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
Total Amount Due
NOR LIMIT IN ANY WAY THE CITYS AS UTY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapainsp.
Receipt #
1 HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
P
APP ICATION AP ROVAI
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTAUC-
CALL
This appfl�lnlm Is not a munil unlit signed by the
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION YN -Me OF THE STATE OF WASHINGTON RELATING TO
OF I
FOR INSPECTION
Bleldil Offiel.) W his/her Banner: and Fee, am paid.
f,' seallu Is ren—Lauglut in space pra4dmd.
�CE AND RCW 18.27�
WORKMEN'S COMPE;:OIC`N11)4SJRA
SKINAT DA
UPI
(425)
;�"IALS
771-0220Q
14ji'D'i
GA
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI-
-JORIGINAL. F YELLOW.. INSPIi
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK � OWNER GOLD - ASSESSOR
10/01
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing .............
Wall .............
Pier/Porch .................
z
0
Retaining Wall
-4
0
Slab Insulation ..........
M
PLUMBING:
Underground
0 M
Rough -In ............
171
0
0
Commercial Final
C
M
HEATING:
ITI
,Gas Test .................
Gas Piping
Equipment ..........
0,n
Commercial Final
M M
EXTERIOR SHEATHING
0
NAILING ............
0
FRAMING
C
9
M 0
FIRST FLOOR FRAMING
INSULATION
Floor Insulation
z
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
z
0
SPECIAL INSPECTION
ITI
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................