20020253.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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ULING ADDRESS
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PERMIT OU IRES-4
use PERMIT
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NUMBER —
JOB A
ADDRESS
FLAT NAMEISUBDIVISION NO.
LOT NO.
L�D NO.
L D FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
rE.
F_ R
EXISTING — PROPOSED
REQUIRED DEDICATION— FT
Y,.ft
METER SIZE
LINE RITE�'
PAY EQUIRED
I
Be 0 NO E3
A MARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
ML I_LL
FIRE REVIEWED BY DATE
CITY ZIP
T
7LI
0 0
1,
4E EXPIRATION DATE
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INSPECTION
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$EPA REVIEW
COMPLETE , EXEMPT
EXP
SIGN AREA
ALLOWED PIOPOIED
HEIGHT
ALLOWED I P1101011
PROPEITTYTAX ACCOUNT PARCEL NO. 1—
06'.-
0 NEW RESIDENTIAL / MECH
'tKPWMStNG
LOT COVERAGE
ALLOWED PROPOSED
FT.
REQUIRED SETBACKS I I
FRONT SIDE REAR
PROPOSED SET CKS (FT.)
SA EAR
FRONT URSIDE A
0 ADDITION 0 COMMERCIAL o C MPLIANCE OR
CHANGE Of USE
EMODEI 0 APARTMENT 0 SIGN
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P.K'1'
PA KIIN3 I
ROV'Be
REOD I PROVIDED
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LOT AREA
P NNING REVIEWED BY DATE
FENCE
0 REPAIR 0 GRADING ,, o FE CE
X
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I _ _ I
REMARKS
AR
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OTHER
0 DEMOLISH 0 TANK 0 OTHER
ill
o GARAGE 0 RETAINING WALL
A�N.AL
CARPORT ROCKERY 0 RENEWAL
IFIRE
(TYPE OF USE, BUSINESS OR
CHECKED BY
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0 UPAN
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NUMBER
OF
TORIES
NUMBER IF
WELL NO
U NITS
CRITICAL
AREAS
NUMBER
�T'
SPECIAL INSPECTOR JAREA
I
A
REQUIRED 0 YES
OCCUPANT
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
JA) Ax� /VCWJ ZjLA
04 o t
Plan Check
HEAT SOURCE GLAZING %
LOT SLOPE %
Building
PLAN CHECK NO:
VESTED LATE
Plumbing
rGrading
Mechanical
THIS PERMIT AUTHOIDIZES ONLY THE OAK NOTED. THIS PERMIT COVERS WORK TO
t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 DOMIUN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
R�Vew
SEPARATE PERMISSION.
PER A'App"C'no" INDAYS
_�ngr.
PERMIT UMM I YEAR - PROVID D WORK IS STARTED WITHIN Iss DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
Traffic Mitigation
Fire Review
a EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, MD AGENTS FROM ANY AND
ALL CLAMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
— —
Fire Inspection
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
9 0 EMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE
0 NORLIMITINANYWAYTHEC S ABILITY TO ENFORCE ANY ORDINAI—E.—
Landscapainsp.1
—
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIOW THAT THE INFORMATION
GIVE" IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNS . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
. VIOLATION OF THE LABOR ODE OF THE STATE OF WASHINGrON RELATING TO
FOR INSPECTK
WORKME�;AJOVMEIISATION INSURANCE AND ACW 18,27.
a' IS
(425)
AE—NT10A
771-0220
EXT 1333
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. LIED SECTION 109
FAX
10/01
Description FEE
eul � S C L)
Recording Fee
City Surcharge '15
State Surcharge
Plan Chk Deposit
Receipt III
TotalAmoumDue
Receipt #
N APPROVAL
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ORIGINAL - FILE YELLOW - INSPECTOR
PINK � OWNER GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACK$ .....................
FOUNDATION:
Footing ......................
Wall............... ..........
Pier/Porch .................
z
0,
Retaining Wall ...........
M
Stab Insulation
PLUMBING:
Underground .............
a
C
M
0
Rough -in . ................
-40
Commercial Final
0
M
HEATING:
Gas Test:
Gas Piping
............
Equip ment .................
0 -n
n
Commerci,�l Final
M M
EXTERIOR SHEATHING
1
0
NAILING .................
017 n
C co
FRAMING ...................
C co
I'D 0
FIRST FLOOR FRAMING
z
INSULATION ...................
Floor Insulation
Wall Insulation ...........
-4
x
Ceiling Insulation
z
9
SHEETROCK NAILING
0
SPECIAL INSPECTION
M
MISCELLANEOUS
FINAL APPROVAL FOR
7?_
OCCUPANCY ..................
A -
coop. .2rA000,