20020314.pdfPERMIT EXPIRES
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CITY OF EDMONDS
USE
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PERM T
IN U M EIE R
CONSTRUCTION PERMIT APPLICATION
JOB
ADDRESS
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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1111TING— PROPOSED—
REQUIRED DEDICATION— Fr —
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PrW REQUIRED
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YES E3 NO 13
RESS
REMARKS
OWNERICONTRACTOR RESPONSIBLE
FOR EROSION CONTROUDRAINA
Regardless (31 watE�
is open or clo�i,;��, tanks are
raqulmd on all b(A tanks per
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STATE LICENSE NUMBER EXPIRATION,7
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PROPERTY TAX ACCOUNT PARCEL NO.
FIRE REVIEWED BY DATE
VARIANCE OR CU SHORELINE OR ADB# IN715.�KCN
[3YES 13NO
SEPA REVIEW SIGN AREA HEIQHT
COMPLETE EXEMPT ALLOWED , PROPOSED ALLOWED IR011MID
EXP
Era
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED 8 ACKS (FT.)
RESIDENTIAL MBING MECH REAR FRONT URSIBE FEAR
0 NEW El P
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CONI.B.C.I.
ED
C MPLIANC
CHANGE OF USE
ALLOWED PROPOSED FRONT SIDE
'A:V0eVIB TLOLAP" D BY DX
REMODEL
APARTMENT
0 SIGN
REal . DED
quired on fuel- turning pliances in
REPAIR
[3 GRADING CYDS
13 (FENCE X FT)
_
FIRMA R Unheated spacm UNIC 815.7
0 DEMOLISH
0 TANK
OTHER
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BTA WALL
R ING
CARPORT
0 OCKERY
IENEWAL
ITYPE OF USE, OR ACTNP- - . .....
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NUMBER I
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GROB
—U. No,
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RIES
UNITS,
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0 YES
DESCRIBE WORK TO BE
DONE
M
INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
APRESSURE
Plan Check
HEAT SOURCE G�ING % LOT SLOPE %
Building
PLAN CHECK NO: VIIETED�TF
E
Pounl"Dig
LGrading
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
IT "
IN
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
g
Recording Fee
C) WLL R.
:1 DOMAIN JCUADS, SIDEWALKS, DRIVEWAYS MARQUEES. ETC.) WILL REQUIRE
h SEPARATEPEAM;SSION.
Engr. Review
City Surcharge
PC MffAPPUCATION: INDAYS
PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLIC'NT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN iNTERESt, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLE- '" "'
ANY AND
Receipt #
3 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM
IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
OF THIS PERMIT SHALL NOT BE
Fire Review
FROM THE ISSUANCE OF THIS PERMIT. SSUANCi
9 DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE
Fire Inspection
o NOR LIMIT IN ANY WAY THE CITYS ABILITY To ENFORCE ANY ORDINANCE PROVISION.-
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Landscapelnsp.
I HEREBY ACKNOWLEDGE T AT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE WNER IAGIIEET H CITY AND STATE LAWS REGULATING CONSTRUC.
0 'TH
CALL
a- I-- I -Ded -111.19ndbyei.
. ND.�.O'N.T ORK AU 0' EREBY� NO PERSON WILL BE EMPLOYED
T ON?A FZC. T.
BE CF THE STATE OF WASHINGTON ITELATIN. To
IN VIOLATIO� OFPN?IrN
RN
P:'� and Fees ale paid, w,d
FOR INSPECTION j
LPM " ,
WORKMEWS 1�GN E E ANP RCW 1..27.
I
WNER'�'I"j DATE SIGNED
(425)
;F
771-0220
R ALD�Sy DATE
N
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 CERTIFk
BRIG NAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall .................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final
HEATING:
Gas Test ..........
Gas Piping ..................
Equipment ...........
Commercial Final
EXTERIOR SHEATHING
NAILING . .......................
FRAMING ....................
FIRST FLOOR FRAMING
INSULATION ............
Floor Insulation
Wall Insulation
Calling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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