20020334.pdfDATE RECEIVED
ommommounsenom�
CITY OF EDMONDS
CONSTRUCTION PERMIT APPUCATION
�71VESSI?
ING ADDRESS
V0 5 —.2—In
FaTy ,645LEPHONE
A)!)"
IIP
IT 111"ONE
ADDRESS
cy q3 t,-7 �jj
WE 11E"IE NUMBER, EXPIRA,ajN DATE C
PA
PROPERTY TAX ACCOUNT RcEL NO* 31
Z-70 4/t3o 00 -
0 NEW ... K)rNTIA1 PLUNSING(�)
C MPLVNCE OR
ADDITION COMMERCIAL 0 CHANGE OF USE
REMODEL APARTMENT SIGN
REPAIR [3 GRADING Cyca 'tENCE X FT)
[3 DEMOLISH TANK OTHER
0 GARAGE 0 N-0C`Ka.,N,3 WALL 0 RENEWAL
CARPORT
ITYPE 0 BE, BUSINESS OR ACII�V
4g- b 4--
OF
NUMBER NUMBER F
OF 'WELLING
CRITICAL
ARE
Net AS
o
STORIES U
DESCRIBS WORK TO BE DONE
:�L4 (!"C— U/ L t-14
<
PERMITEX22!!
E PERMIT
NUMBER
DNE
3S SUITFJAPT#
DDA 0
PLAT 71NAMEISUBDIVISION 7NO, T:TNQ LID' NO,
Lo
LID FEE $
G
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP a, R
�S,a� I �U= P R."d
Gross �eea R
EXISTING — PROPOSED —
REQUIRED DEDICATION— FT
W.—
'IN 'a.0
METER SIZE LINE SIIE NO. 01 IIXIURE. IRV REQUIRE
Y 's. .0
ES NO
.NGINEERING I 1�pe B or L vent co I n Be etor I s
IIIII; uppmLances in;
"R' RE"Tuyniteatted spaces. UNIC 815.7
SHORELINE
VARIANCE OR CU 'W&C P STED
OYES ONO
S R rEw
— SIGN AREA
C.M,SIEI'TAE "E"XEMPT LLOWED PROPOSED ALLOWED PROPOSED
P
LOT COVERAGE REQUIRED SETBACKS I PROPOSED SETBACKS (FT.)
(FT. FIGHT UR SIDE NEAR
ALLOWED PROPOSED FRONT SIDE REAR F
PARKING LOT AREA PLANNING REVIEWED By DATE
REaD I PROVIDED
CHECKED By ITYP
TPECIAL INSPECTOI
REQUIRED 0 YES
jo W,/-/ 9,
�la2_C�eok
SOURCE LOT SLOPE
Building
i �_
Plumbing
PLAN CHECK NO: VESTED DATE
Mechanical
THtSPERMITAUTHORInS ONLyTHEWOKH.0TED Hj"S.PEAM.g0CpVERS WORK TO
ST QIRO N a
PROPERTY ON LX A C6NT
Grading
BE DONE ON PRIVATE RPUBUC
DOMURN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL EQUINE
SEPARATEPERMISSION.
En9r, Review
PERMITAPPLICATION: IN DAYS
PERMIT UNIT, I yUR. PROVIDED WORK 15 STARTED WITHIN 180 DAYS
Engr Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-A PLI A , E LD AR LESS THE CITY OF
T INDEMNIFY. DEFEND AND
Tj,sllio� Milipallon
I I ERE , A REES
ED DS, ASHIN T S FFICIAUS.E P YEE$, DA ENTSFRO ANYAND
' F HATEVER NATURE, ARISING DIRECTLY INDIRECTLY
Say
I,. R.v!�
tL F R A A
FRO TH IS LAN E OF IS PERMIT ISSUANCE OF THIS PER, IT $HALL NOT BE
CITY ORDINANCE
� At E OR REDUCE ANY REQUIREM M
IT ME DI E OF ANY
N R LI I T E 1 8 ABILITY TO ENFORCE ANY ORDINANCE PROVISION�*
I IN
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICAT.tON THAT THE INFORMATION
I LL� NORIZED AGENT OF
on H UL
GIVEN IS CORRECT; AND THAT I AM THE OWYNEJA6
THE -N. 'AGREE TO Co. "-'I. IT art IS LAWS RAEUGTULATING CONSTRUC-
BE EMPLOYED
CALL
. THERE. No PERSON WILL
ICAU I GOING .E W.R1`1`AUT-.SC.E HE STATE OF WASHINGTON RELATING TO
CODE OF T
FOR INSPECTK
IN VIOLATION OF THE LABOR
WORKMEN'S CoMpENsArpWINSURJOICE AN RCW 18,27�
A E ;70 a G7
SIGNATURE (0 7 LATV'
(425)
wZ...
771-0220
EXT 1333
ATTENTION
UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
IT is
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
A FINAL
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
REaD
Recording Fee
City Surcharge
state Surcharge
Plan Chk Deposit
Receipt #
Total Amount Due
Receipt #
,,III "glad by the
.1ad Foes ate paid. and
ONIGNAL-FILE YELLOW, INSPECTOR
It
PINK -OWNER GOLD -ASSESSOR X/
z
0
M
TR
ITI 0
0
C
M
In Z
10-4
c:
co
0 -n
'n
Fri M
C) @
0
0 Fn
C D)
9 (j)
M 0
Z r
z
0
i
0
171
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Well
Pier/Porch ............
z
Retaining Wall ...........
Slab Insulation
A
PLUMBING:
3:
Underground .............
0 M
C
1
M
0
Rough -In ............
0
Commercial Final
-q K
HEATING:
3: M
M
Gas Test
Gas Piping .................
0 _n
Equipment
Commercial Final
X
M ITI
EXTERIOR SHEATHING
0
NAILING ..........................
0 Fn
a CA
FRAMING ..........
w
FIRST FLOOR FRAMING
ro
INSULATION ...................
-4
Floor Insulation
z
Wall Insulation
Ceiling Insulation
SHEETROCK NAILING
z
-04
0
SPECIAL INSPECTION
IT!
MISCELLANEOUS ..........
���!�MOVAL FOR
02-