20020161.pdfSM DATE RECEIVED
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
CITY
PERMIT EXPIRES 2f
ZONE PERM T
9'�� NUMI'ER
ADDRESS 0� _- SUtTE/APT#
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PLAT IIAMEISURDIVISION NO. I LOT NO. L�D NQ
L D FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED-
13
REQUIRED DEDICATION— FT
13
METER SIZE I LINE SIZE YEPAV nEOUIRED
S 0 NO C3
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTRO I I to
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ADDRESS
ENGINEERING
REVIEWEDIDATE
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CITY I TELEPHONE
FIRE REVIEWED BY
DATE
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SHORELINE OR ADB#
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ALLOWED PROPOSED
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LOT COVERAGE
REQUIRED SETBACK$ (FT.)
PROPOSED SETBACKS (Fr.)
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ALLOWED PROPOSED
FRONT SIDE REAR
FRONT i REAR
ADDITION
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SIGN
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REMARKS
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OTHER
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GARAGE RETAINING WALL
CARPORT U ROOKERY
RENEWAL
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NUMB R NUMBER OF I
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SPECIIALEINSPECTO
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ITS
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DESCRIBE WORK TO BE DONE
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..OGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
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Building
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VESTED DATE
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THIS PERMIT AUTHOSIZES ONLY THE WORK .*IED. THIS
PE WORK To
as
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Mechanical
Me-h.nd.al
k
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
U-i
DOMAIN SIDEWALKS,
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Grading
Recording Fee
(CURBS, ORIVENOWS. MARQUEES, ETC.) WILL REQUIRE
3 ST
it: SEPARATE PERMISSION.
2-
5
gr. R View
Engr. Review
City Surcharge
b
PERMITAPPLICATI N: IWDAIS
I PERMIRT UMM. I YEAJR - PROVIDED WORK IS STARTED WITHIN 110...
DAYS
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
State Surcharge
*APPLICANT ON 81-LF (11 HIS -11 -Be �POUSI. H1111s, ASSIGNS AND SUCCES.11S
IN IWEAEST, AGREES
Traffic Mitigation
Plan Chk Deposit
To INGEMNI, DEFEND AND H.10 THE CITY 01
'GMO S, WASHINGTOl,L ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY
Fire Review
Receipt #
OR INDIRECTLY
FROM THE ISSUANCE (11 THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED To MODIFY, WA E OR REDUCE A14Y REOUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
TotalAmountDue
NOR LIMIT IN ANY WAY TIVE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapoinsp.
Receipt #
I HEREBY 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
APPLICATION
APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC,
11014�.ANO RN000i W AUTHORIZED THEREBY, NO PE SON WILL BE EMPLOYED
CALL
1. n— pd-i-01 sip,di by M.
V LATO E OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Rd"Thl-ppk.fid.
ding OffidWI., hl,Iffid, D.puly:.�d F-- p.1d. ;vd
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ION UW
Wq=EN'S COMPE UION URANCE AND ROW 10.27.
Sll��LUAE IOWNE 11 1113EN
DATE SIGNED
(425)
OFF
I�AL . S SIG'NATUR DATE
771-0220
V-L ce
-ATTENTION
EXT 1333
ED By "AT
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
ORONAI - F-- F YELLOW INSPECTOR
PINK - OWNER GOLD ASSESSOR
10/01
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SET BACKS .....................
FOUNDATION:
Footing ...............
wall ...........
Pier/Porch .............
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ... ................
Commercial Final
M
HEATING:
0
GasTest ....................
M
10
Gas Piping ..............
-4
Equipment .................
3:
Commercial Final
EXTERIOR SHEATHING
It>
NAILING , .........................
M 171
FRAMING
..............
0
FIRST FLOOR FRAMING
INSULATION
..........
Floor Insulation
Wall Insulation
Ceiling Insulation
z
(y) S,
SHEETROCK NAILING
SPECIAL INSPECTION
z
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
3
OCCUPANCY