20020308.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF 8 SINESS
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PLAT NAME/SUBDIVISION NO.
LOT NO
LID NO,
LID FEE s
PUBLIC RIGHT OF WAY PEA OFFICIAL STREET MAP
EMSTIN. — PROPOSED
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REQUIRED DEDICATION— FT —
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PAV REQUIRED
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTR
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NAME jJ01'r j/fLLmyIrI
�O [EN.INEEIUN. REVIEWEDIDATE
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1-1231 ltlk,�-(qja,6461 FIRI REVIEWED BY DATE
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TTATE LICENSE NUMBER EXPIRATIO1 CHECIIII By
ANCE OR CU
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SHORELINE OR ADIHF
INSPECT107NION.D.
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ALLOWED , PROPOSED
HEIGHT
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P�NEW LOT COVERAGE IRED SETBACKS TT.) PROPOSED 'Ertl's III
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REMODEL
REPAIR
APARTMENT
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A PARKING LOTAREA I PUNNING REVIEWED
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REMARKS
BY DATE
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[3 TANK
[3 RETAININ WALL
ROOKERY
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NUMBER
NUMBER OF
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OF L WELLING AREAS BPECIAIE.I.SPECT.. JAR.1, P.
REDU A LOAD
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STORIES UNITS NUMBER 0 YES
DESCRIBE WORK TO BE DONh
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REMARKS
PROGRESS INSPECTIONS PER UBC 11001FINAL INSPECTION REITO
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VALUATION $
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Description FEE Description FEE
Plan Check
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HEAT SOURCE GLAZING I
LOT SLOPE 1, Building
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PLAN CHECK NOt VESTED DATE Plumbing
Mechanical
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THISPERMITAUT OBOES ONLYTHE WORK NOTED. THIS PERMIT COVERS WORKTO
BE III I" PRIVATE PICIPIRITY INI CON11110"I"I"El"811
Grading
Recording Fee
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
t: SEPARATE PERMISSION.
Engr.
City Surcharge
PER ITAPPUCATION: IMODAYS
PERMIT LRIUR I YEAUD. PROVIDED WORK IS STARTED WITHIN IBODAYS
rRoview
Engt Inspection
State Surcharge
SEE BACKOF PINK PERMIT FOR MORE INFORMATION
-ILICANT ON BEHALF 011111 OR HER SPOUSE, HEIRS. ASSIGNS AND IUDCES.RS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREED TO INDEMNIFY� BE ND AND HOLD HARMLESS THE Oil OF
Receipt #
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ADDING DIRECTLY OR INDIRECTLY
Fire Review
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
MODIFY�YWAIVE OR REDUCE A Y REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
Total Amou=��
=ITO
PRO
rINANYW T HE CITY'S ABILITY TO ENFORCE ANY ORDINANCE —_ VISION.-
Landscape
I HERE ACKNOWLEDGE THAT I RAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVE IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
This app""On is "I . P-11 rifil sigmd by th.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
CALL
D.P. Fp Id,.
Iy:`;tF`s' P
Bulid��h.
IN VIOLATION OF TH LASOITZME OF HE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
1.1hl�Vhiv
. i ' _'. dg.d4,1 P�QW.
WORKMEN'S COMPENSAT)OWKWIVINCE AND RCW 111. 7,
F11t LS UBE ATE
e (OWNER OR DATE BI.NE.
(1425)
:Z= 4
771-0220
FA$Eb By DATE
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-
ORIGINAL -FILE YELLO -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNE GOLD - ASSESSOR
10101
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
Wall....................
Pier/Porch .................
Retaining Wall ...........
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0
Slab Insulation
Q1
PLUMBING:
4
Underground .............
Rough -in
A -,9 4- o.2-
a ITI
...................
C:
M
Commercial Final
0
0
HEATING:
C
IT
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Gas Test ....................
ID
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
M IT
NAILING ...................
FRAMING ............. ..........
0 M
FIRST FLOOR FRAMING_
M 0
INSULATION ...................
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Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
0
IT
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................