20020272.pdfAW DATE RECEIVED
PERMITEXPIRES
CITY OF EDMONDS
us' PE M T
Z UR
N M1'ER2V2- (22-7 2-
CONSTRUCTION PERMIT APPLICATION
'A'DDRESS QIuTF1APT#
PLAT NAME/SUBDIVISION NO. LOT No. I: 0.
MAILING ADDRESS
-7100- 1�2L 51,j
L 0 EE$
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP A.s.
pe-, as
1
CITY ZIP ITELEPHONE
L
EXISTING — PROPOSED — 'Pers"A n.,_
sar—rin-i I
REQUIRED DEDICATION— FT U.Aea_A
— irunraad 13
IMETER SIZE I
LINE 1111
1 NO- OF Fl—R11
P V 11OULIED C,
YES C3 No 0 3
ADDRESS
REMARKS
WNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY
PURsumrrro UPC 605.2
NAME
AWA
ON THE
It
ADDRESS
ITT
ENGINEERING
LIM ASIT ENTERSTHORMM'll-I
o
AA1Xx-_Q
FIRE REVIEWED BY DATE
CITY ZIP TELEPHONE
x
VARIANCE OR CU SHORELINE OR ADS# INSPECTION BOND
STATE LICENSE NUMBER EXPIRATION
RE Q POSTED
13YES C3NO
PROPERTY TAX ACCOUNT PAR
SEPA REVIE S U '4e13VPUW QAdEll
0
C PLETE EXTWR WE P OPOSED
A LVETRVI
E XP
RESIDENTIA
NEW SON
UM-'N
0 OPLIAND'E
LOT, OVERAG D SET Its (FT.
ALLOWS C PROPOSED ONT UR SIDE AFAR
ADDRION COMMERCIAL El CHANGE OF USER
LAt
0 A EMODEL 0 APARTMENT E] SIGN
G ARKING LOT AITNNIN REVIEWED BY DATE
Reop I PROVIDED A.
REPAIR 0 GR40ING Cy.. FENCE
I _ X
Fn REMARKS
DEMOLISH TANK OTHER
se
GARAGE RETAINING WALL [3 RENEWAL
CARPORT ROOKERY
(TYPE OF USE, BUSINESS OR
CHECKED BY ST7 -71 OCCUPANT
NUMBER NUM ER 11 CRITICAL
.5iON
12� 1 AOL,
, '7j
I SPECIALE.INSPECTOR 1 OCCUPANT
OF WELL No AREAS
STORIES/ UNITS NUMBS A
DESCRIBE WORK TO BE DONE
ASOU A JAREA LOAD
Yes
REMARKS
PROGRESS INSPECTIONS PER UBC 1081FINAL IN SPECTION REDID
k
Sf_2
104-- 1,4—
CIV6 -2
VAILLIATION $
Plan Check
HEAT SOURCE GLAZING 94 LOT SLOPE 16
Building
PLAN
lumbing
Mechanical
THIS PERMIT ALANIORIZIES ONLY THE WORK NOTES. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLI
C
Grading
Recording Fee
DOMAIN (CUFISS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SERARITEP RMISSION.
PEAMITAIPPLICATION: INDAYS
Engr. Review
City Surcharge
PERMIT LOATA I YEAR - PROVIDED WORK is STARTED WITHIN I's DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER IPGUI.� .,,AS ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARM - - - i T .1
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR RE U E ANY REQUIREMENT OF ANY CITY ORDINANC
DASILAY
Fire Inspection
Total Amount Due
0 NOR LIMIT IN ANY WAY THE DAYS TO ENFORCE ANY ORDINANCE PROVISION. -
Landscapoinsp.
Receipt#
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAI THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT AM THE OWNER, OR THE OULY AUTHORIZED AGENT OF
THE OWNER. JAGRES To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
I as lra, net a pannit until signed by An,
a'sts,
TIOR AND IN DOING THE WORK AU IHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR Co OF WASHINGTON RELATING TO
THE $TAT
FOR INSPECTION
Sinaillappll
A
Ing0tricial liar epaily: and Foes are Paid, And
n-1,41A 'cli'medpal repacepran,tdod.
WORKMEN'S,900KASATION AND RCW 15,27.
INS J�W
OFFICIAt.IrN&ATRE
0-1 SIGNED
(425)
r._
ir
I -wr
-�w
"tLEASEb BY
ATTENTION
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-
ORIGINAL � FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION IOD
FAX
PINK - OWNER GOLD - ASSESSOR
10/01
z
0 In
C 0 ,
--j '0'
0 C
-4 C
X M
1111
0 -n
n
_q
1111 ITI
0
0
0
C
00
M 0
z
21
--I
z
C/)
z
0
:j
0
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
S
SETBACKS ...............
FOUNDATION:
Footing ...............
wait .............
Pier/Porch
R.tilnihly will ...........
Slab Insulation ..........
0
PLUMBING:
Undergrounct .............
rn
C
Rough -in ...........
RR
0
0
Commarclat'Aiiii
C
L
HEATING:
A
V
Gas Test ..............
Gas Piping ................
a
�2
Equipment ..........
0 -n
Commerclal'Final
3:
M
EXTERIOR SHEATHING
a
NAILING
0
0
FRAMING . . ....... ................
0
FIRST FLOOR FRAMING
INSULATION. .2,; .............
Floe, insulation
z
Wall Insulation
Calling Insulation
Cc
NAILING
z
SKETROCK
0
SPECIAL INSPECTION
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .................