20020296.pdfDATE RECEIVED J
2 14) —i 2 PERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT
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NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB SUITEIAPT#
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OWNER NAMEINAME OF BUSINZ
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PLAT NAMEISUBDIVISION NO, LOT NO LID NO.
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FEE $
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NO. OF FIXTURES
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSICN CONTROLIORAINAGE
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NAME
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ENGINEERING REVIEWEDIDATE
ADDRESS
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FIRE REVIEWED BY DATE
CITY
TELEPHONE
STATE LICENSE NUMBER
EXPIRATION DATE CHECKED BY
VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND
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REDD POSTED
E3yEE E3NO
SEPA REVIEW SIGN AREA HEIGHT
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PROPERTY TAX ACCOUNT CEL NO,
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
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LOT C VERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS IT
ALLOWED G PROPOSED FRONT SIDE REAR FRONT US SIDE REAR
0 ADDITION 0 COMMERCIAL
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CHANGE OF USE
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REG, PARKING LOT AREA PLANNING REVIEWED By
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0 REPAIR [3 GRADING 0 F NCE
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REMARKS
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DESCRIBE WORK TO BE DONE
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REMARKS
PRIDGIRESS INSPECTIONS PER USC 1081FINAL INSPECTION REO'D
Plan Check
HEAT SOURCE
Building
PLAN CHECK NO:
1
Plumbing
Mechanical
THIS PERMPT AUTHORAZES ONLYTHE wonK NOTED. THIS PERMIT COVERS WORK To
t: BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTR CTIONONTHEPUBLIC
a
Grading
Rocarding Fee
Do MILIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERM"TAPPLICATION: ISDIDAYS
Engr. Review
City Surcharge
YEAR - PROVIDED WORK 15 STARTED WITHIN IWDAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO RIDE.NII DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND
Fire Review
Receipt #
IALLCLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
!3 0 TOMODIFYINAIVEO REDUCE ANY REQUIREMENT OF My CITY ORDINANCE
Fire Inspection
Total Amount Due
N=T IN ANY WAY THE CrYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION!
Landscapensp.1
I Receipt
I HEREBY ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT AM THE OWNER, OR THE DULY AUTHOR ZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONS1 RUC�
CALL
TbI-ppfi,..tIo.Nn...P—It. 1.1 dbyft
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
B.Ildng Offid.l.r h6ftl D.P.1y: .'d" Fo�',"— P.Id—d
FOR INSPECTION .... IpI I—k-10g.d h �p— p—Id.d.
wonKMENS,pliffi-�14DATION INSURANCE AND ROW 18.27.
OFF I I NAT
AGENT) DATE SIGNED
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7-71-0220
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ATTENT40N V �-j
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-FULE - YELLOW � INSPEC(TOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
PAY
PIMK�OWNER - GOLD,ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...............
FOUNDATION:
Feeling ......................
wall ..........................
z
Pier/Porch .................
0
Retaining Wall ...........
M
Slab Insulation ..........
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PLUMBING:
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0 M
Underground ..........
C 0
M
0.
0
Rough -in � .................
Commercial Final
X rn
M z
HEATING:
C
Gas Test ............
Gas Piping ............
0 -n
Equipment
Commercial Final
M M
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EXTERIOR SHEATHING
0
oFn.
NAILING
C: (A
..........................
FRAMING ...............
M 0
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Y/all Insulation ...........
Ceiling Insulation
z
0
SHEETROCK NAILING
0
M
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................