20020303.pdfDATE RECEIVED =PERMIT EXPIRES
USE PERMIT
CITY OF EDMONDS ZONE 'P.Zf�, NUMBER(5 d3��3
CONSTRUCTION PERMIT APPLICATION Joe SUITEIAPT#
ADDRESS ALC�r,7
=Z7, Nx-7 PLAT NAME/SUBDIVISION NO. LOT NO. CIO N .
ING ADDRESS LID FEE S
11 -p-ad
PUBLIC RIGHT 01 WAY PER OFFICIAL BEST MAI BW
-LA /_\' L_N-'x-:-_ g- She.
IT11111IONE EXISTING - PROPOSED- In.psmin""U", 13
13
REQUIRED DEDICATION- FT - 0
E METER SIZE I LINE SIZE I NO. OF IIXTUIES 0
YES NO C3
BESS
REMARKS ce
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
re
CITY
NAME
ENGINEE&�'-/' REVIEWED/UATE
se ADDRESS
*2
z
0
M
'4"fi
In
FIRE REVIEWED By DATE
CITY ZIP
L
ITILEPTIONE
AQ -7
STATE LICENSE NUMBER EXPIRATION DATE
IdEcKeD BY
VARIANCE (111 CU
SHORELINE OR ADS#
INSPECTION
REO'D
0Y a
BOND
POSTED
P""' EL NO.
I e(5";PA' -7- ,vo 06
$EPA REVIEW
Cc
E XPM11ETE , EXEMPT
I.. AREA
ALLOWED , PROPOSED
HEIGHT
ALLOWED , PROPOSED
0 NEW 0 PLUMBING I MECH
E] ADDITION Ei C MPUANCE OR
CHANGE OF USE
[j REMODEL n SIGN
REPAIR 0 GRADING Y., o FENCE
EMOLISH I - x F1
El TANK 0 OTHER
LOT COVERAGE
ALLOWED PROPOSED
REQUIRE SETBA KS (Fr
FRONTO SIDE C REAR I
PROPOSED SIETBACKS (FT)
FRONT U. SIDE HEAR
a IT
C:
tin 0
0
ce 0
= M
rR
PARKING I
FIECIT) I PROVIDED I
LOT AREA
I PLANNING REVIEWED BY DATE
I
R
GARAGE RETAINING WALL
CARPORT ROOKERY RENEWAL
to
0 In
-4
x
in M
a ra
(TYPE OF USE, BUSINESS OR IV" EXPLAIN:
10F
�A;
4';
CHECKED BY
ITY&OF COAST LICTION
C4?
O111PANTL
GROUP
or STORIES
HUM ER OF I CRITICAL /rr/i
WELL No AREAS
NITS NUMBER e1jq a2-
SPECIALEIDNSPECTOR
R [AREA
R
EDO YES
OCCUPANT
LOAD
DES!j!&�ORK TO �EDONE
REMARKS ce
0
0
ROGRESS INSPECTIONS PER UBC 108/171NAL INSPECTION REDID
C CO
K 4:1)
M 0
ALUATION $
V VALUATION
z
ot
FEE
Description
FEE
Q.� I
Ian Check
z
ITI
g4- mMNT
LOT -LO
IL
Building
PLAN CHECT
'�2
VESTED DATE
Plumbing
Plumbing
Mechanical
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Grading
Recording Fee
t: 11 DONE ON P111 PIIEI. .1111. ANY .a..C)N 0. THE PUBLIC
I C
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, E RE
TC.t WILL BEGIN
SEPARATE PERMISSION.
Engr. Review
City Surcharge
PE MrITAPPLICATION: ISD DAYS
PERMIT UMM I YEAR - PROVID D WORK IS STARTED WITHIN ISODAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
State Surcharge
-ILIC . ON IIEH-ALI F HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AN"
ALL CLAIMS Fo DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
I
-
Fire Review
Receipt Ity
Fire Inspection
TotalAmount Due
FROM THE rSSUA CE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT E
DEEMED TO MODIFN, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCBE
n5 0 : NOR LIMIT IN ANY WAY THE cnYs ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION TPPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application Inner a permit until signed by Me
L101.1,,AND IN ZT1, AU1`HGRIZED THEREBY. NO PERSON WILL BE EMPLOYED
'E WORK IN
AT, I.A... OODE OF THE ITAT 01 WWA.. NOTCH RELATING TO
FOR INSPECTION
Bureting Official 0, hismer 01ply: and Foes are paid. and
c.lin I-sk-ledgmil In spers. P-ld.d.
'..E
W. HE C'ON'..URANCE AND ROW 18.27.
(425
0 DATE
JZIG�R ER AGE
A E IGNED
I I I .`Llhr.�w RELEASED BY AGATE
ATTENTIbA EXT 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 ORIGINAL � FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 FAX PINK, OWNER - GOLD - ASSESSOR
10/01
91
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall ....................
z
Pier/Porch .................
0
Retaining Wall ..........
Stab Insulation
PLUMBING:
M
C:
Underground .............
ITI
0
--10
Rough
-in ...................
C
-4 M
Commercial Final
RR
z
HEATING:
C
Gas Test ....................
Gas Piping
on
Equipment
M M
Commercial Final
EXTERIOR SHEATHING
0Fn
NAILING ..........................
C 0)
0
FRAMING ........................
FIRST FLOOR FRAMING...,
W
INSULATION ...................
z
Floor Insulation
Wall Insulation ...........
z
Ceiling Insulation
SHEETROCK NAILING
0
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................