20020175.pdf444 DATE RECEIVED
1PERMITEXPIRES
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CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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PROPERTY TAX ACCOUNT PARCEL NO. Ee ALI.
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13 NEW RESIDENTIAL LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT)
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DESCRIBE WORK TO BE DONE
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PROGRESS INSPECTIONS PER INIC 108/FINAL INSPECTION REOM
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VALUATION $
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FE Description FE—E
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HEAT SOURCE GLAZING % LOT SL OPE I
B uilding
PLAN CHECK NO: VESTED DATE
Plumbing
Mochanicni
THIS PERMIT AUTHORLUS ONLY THE W RK NOTED. THIS PERMIT COVIR. WORK 1.
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUDLI
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GMAIN (CURBS, SIDEWALKS, DRIVEWAYS UAROUEES, ETC.) WILL REQUIRE
Grading
Reco.-ding Foe
3
SEPARATE PgAMISSION.
PERMITAPPUCATION. IS0DAYb
Engr, Review
City Surcharge
PERMITIUM 11 YEAR- PROVIDED WORK 18 STARTED WITHIN INDAVS
Engir. Inspection
State Suirchadge
SEE BACK OF PINK PERMIT FOR MORE, INFORMATION
;A.PPUCI . ON BEHALF OF HIS OR HER SPOUSE, HEIRS ASSIGNS AND SUCCESOIIS
Traffic Mitigation
Plan Chk Deposit
.TER
INTER 'ST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS INS CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS* EMPLOYEES, AND IKENT5 110 ANY AND
M
A L CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING D ON INIIIICIIY
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It- THE I IUANCE 01 THIS 9EIIIII. ISSUANCE 01 THIS PE`A`MF SHAIA N E
DEEMED To MODIFY, WAIVE 08 REDUCE ANY REQUIREMENT OF ANY CRY ORIAHANSE
Fire Inspection
Total Amount
NOR LIMIT IN ANY WAY THE C"S ABILITY TO ENFORCE ANY ORDINANCE PROVISION
�Land.capo
losp,
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAI THE INFORMATION
GIVE IS CORRECT. AND THAT I AM THE OWNER. OR THE Duty AUTHonazED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC,
CALL
IN, appW.1- I., a.,. by Ipo
TION; AND IN DOING THE WORK AUTHORIZED 1 HEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN"S COMPENSATIS�WU NCE AND HOW 18,27.
FOR INSPECTION
di'a off""t " h�*;her Oaputy wo fea. a'* paid, md
aupt is acknowledgedo apaca p-Id..,
ATdRE
SIGN ]WHEN OR NED
(425)
Of�lCtA�S /SI NATURE DATE
I&AkL Y
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771-0220
A NTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR
EXT 1333
Y DATE
- ff-6 ZI, vz'�Z/
STRUCTURE UNTIL
INSPECTION HAS BEEN
771-0221
A FINAL MADE AND APPROVAL OR A CERTIFI.
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
FAX
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall.................
Pier/Porch .................
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underound .............
rg
Rough -in
commarcipi Final
HEATING:
Gas Test ....................
Gas PI ping
Equipment ............
Commercial Final
EXTERIOR SHEATHING
NAILING ......................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...........
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
C,
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY
..................
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