20020243.pdfDATE RECEIVED
[PERMITEXPIRES
CITY OF EDMONDS
CONSTRUCTION PERMIT APPUCATION
OWN7MEMAME
OF BUSINESS
t C-�)a'/) -,t
JE
MAILING ADDRESS
C14
TELEPHONE
(I
A 25 _-t-ML
NAME
PADI—jSSa�L
CITY
TY ZIP
11EIEPHONE
IIAMtk)(,
C_C) ML181
ADDRESS
ZIP IT11EPHON1
STATE LICENSE NUMBER EXPIRATION
CHECK
PHOPERTYTAX ACCOUNT PARCEL NO.
0 NEW 96ESIDENTIAL PLUMBING I MECH
[j ADDITION COMMERCIAL COMPLIANCE OR
C ANGE OF USE
�16 EMODEL APARTMENT SIGN
0 REPAIR 0 GRADING F NCE
Y.E ( _X_FF)
0 DEMOLISH fj TANK OTHER
GARAGE o RETAINING WALL
CARPORT OCKERY RENEWAL
(TYPE OF USE. BVSINE
All,
C
NUMBER NUMBER OF CRITICAL
DWELLING AREAS 14
UNITS NUMBER
DON.
/�112
HEAT SOURCE B—No,
LOT "LOP,
PLAN CHECK NO:
VESTED DATE
THIS PERMIT AUTHORRES ONLYTHE WORK NOTEM THIS PERMIT COVERS WORK TO
t:
BEDONEGNPRIVATEP OPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
3
M
Do MAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPAUUTEPERMISSION.
PE MITAPPLICATION: ISDDAYS
PERMIT LIMUT I YEABI-PROVIDEDWOR HISTARTIEDWITHIN ISDOAYS
SEE RACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICAN". ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEPEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIM, FOR DAMAGED 0, WHATEVER NATURE, ARISING OIRVCTIY OR INDIRECTLY
FROM THE'SSUANCE 0, THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE
0
NOR LIMIT IN ANY WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE PROVISIONI,'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PE SON WILL BE EMPLOYED
IN VIOLAT�.07 OF TH E THE STAT OF WASHINGTON RELATING TO
WORKMEN E LABOW
OMPENSAMN IN AND RCW 18.27,
to HER 0 G
DATE
..0
_a
USES PERMIT
ZON Ile /1,10
jo SUITEIAPT#
ADDRESS j
PLAT NAMEISUBDIVISION NO, LOT NO. L
L�D NO.
0 FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP .a., 4 —
— peo.'so
thane.m.nann c
EXISTING PROPOSED— encoodc Panama
sat—kn1w,ed
REQUIRED DEDICATION— FT — _1
Ve..'ea.mc
METER SIZE
LINE SIZE
No OF FIXTURES
PRV REQUIRED
U,
I
I
ES 13 NO C3
z
f5
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDMNAGE
I)I,pe B or L vent connectors -
ENGIN q"wred on luel-uurlit,
Odeate spaces, UNIC , 815.7
z
_
FIRE
IC
0
VARIANCE OR CU
SHORELINE OR ADO#
INSPEC'n N
BOND
POSTED
IYREOO
ES C3NO
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HIIPHT
ALLOWED PROPOSED
,
Xle
m
C
LOT COVERAGE
REQUIRED SETBACKS (Fr.) PROPOS
D SETBACK$ OFT)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT US SIDE HEAR
M
z 0
se 0
3: M
PARKING
REDD PROVIDED
LOT AREA
PLANNING REVIEWED BY DZE
I
M Z
10 —4
C
REMARKS
CIO
0 -n
CHECKED BY
FRICTION
11CIPAN;'
ITYPE
GROUP r;�,
rn In
SPECIAL INSPECTOR
OCCU NT
A EOUIRED
soup [:] YES
JAIIA
LOAD
0
0 M
Its
�REMARKS
at
Go
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD
C
IV-1
?a M 0
Z r-
X
z
--I
x
to
z
0
q
0
VALUATION $
Description
FEE
Description
FEE
Plan Check
Building
Plumbing
Mechanical
Grading
Recording Fee
Engr. Review
City Surcharge
Engr. Inspection
State Surcharge
Traffic Mitigation
Plan Chit Deposit
Fire Review
Receipt III
Fire Inspection
Tota[AmountDu.
Landscapainsp.1
Receipt III
APPLICATION At
CAIL L
This spot cation Is not 0 Placed until signed by the
ECTIONI
FOR INSP -
S,Hdlng Oftic�al or his/her Deputy: and Foes am paid. and
me.1p, latickn-ha,gool loop ... PmAd.d.
I OFF)OA4LS SIG)qjTURE E
(425)
771-0220
ATTENTION M 1333
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
10101
44 J ilkln
ORIGINAL - FILE YELLOW - INSPECTOR
PINK -OWNER GOLD, ASSESSOR
FOUNDATION:
Footing......................
wait..........................
Pier/Porch .................
z
..Retaining Wall ...........
Slab Insulation
PLUMBING:
01)
Underground
M
C:
Rough -In ...................
0
0
Commercial Final
__4 K
x M
HEATING:
M
10
C:
Gas Test ..................
>
Gas Piping ............
Equipment .................
-n
Commercial Final
IT11 IT!
EXTERIOR SHEATHING
NAILING ........................
0
FRAMING .................
C Cl)
M 0
FIRST FLOOR FRAMING
z
:24
INSULATION .............
Floor Insulation
z
Wall Insulation
Ceiling Insulation
z
0
-4
SHEETROCK NAILING
SPECIAL INSPECTION
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
too