20020206.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PLAT NAMEISUBDIVISION 140.
LOT 110*
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LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED.
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REMARKS
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STATE LICENSE NUMBER EXPIRATION DATEMY
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SHORELINE OR ADS#
INSPECTION
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COMPLETE EXEMPT
EXP
SIGN AREA
ALLOWED I PROPOSED
HEIGHT
ALLOWED PROPOSED
PROPERTY TAX ACCOUNT PARCEL NO.
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LO COVERAGE
ALLOWED PROPOSED
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11111,11111 SETBACKS IF1,1
FRONT SIDE BEAR
PROPOSED SETBACKS (Fr.)
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DESCRIBE WORK TO BE DONE
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PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REOD
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VALUATION $
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Description FEE Description FEE
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Plan Check
HEAT SOURCE LOT SLOPE %
Building
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PLAN CHECK NO: VESTED DATE
Plumbing
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Mechanical
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I: BEDONEONPRWATEP PERTY ONLY. ANY CONSTRUCTION ON THE PUBLAC
d n
Grading
G 'a g
Recording Fee
DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARGO S, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
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Engr. Review
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City Surcharge
PC MITAPPUCATION: INDAYS
PERMIT UMM I YEAR- PROVID D WORK IS STARTED WITHIN 180DAYS
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Engr. Inspection
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State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
F HI OR HE SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
INL= =F a
Traffic Mitigation
Plan Chk Deposit
T iT.OA TOO I..SEMNIFY. 09FEND AND HOLD HARM—
Receipt # A
EDMONDS, WASHIN N, IT$ OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDMECTLY
Fire Review
FROM THE I SUANCE OF THIS PERMIT ISSUANCE F THIS PERMIT SHALL NOT BE
Fire Inspection
Total Amount Due 5S
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapeinsp.
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIOW THAT THE INFORMATIONE
APPLICATIOWAPPROVAIIL.�-
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
Day
THE OWNER, I AGREE TO COMPLY WITH AND STATE LAWS REGULATING CONSTRUC.
CALL
Is not a ponAft IntH sigmd by UK,
8 So - RE_6FO P G
TION; AND IN DOING THE WO N ERSON WILL BE EMPLOYED
IN VIOLATION OF THE LASC� �GEOEIZTHa SETATE WASHINGTON RELATING TO
FOR INSPECTION
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By
ATTENTION
07 1333
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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-
ORIGINAL -FILE YELLOW. INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK�OWNER GOLD -ASSESSOR
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ....................
FOUNDATION:
Footing ........... ..........
Wall ........... ..............
Pier/Porch ................
Retaining Wall ...........
Stab Insulation
PLUMBING:
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Underground .............
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0
0
Rough-1. .. .................
C
M
Commercial Final
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HEATING:
Gas Test ...........
Gas Piping ...........
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Equipment .................
M M
Commercial Final
CA
0
EXTERIOR SHEATHING
0
NAILING ......................
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M 0
FRAMING ....................
FIRST FLOOR FRAMING...
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INSULATION
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Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
IT!
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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