20020384.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
MAILING ADDRESS
90/5- 2V?,v.P S7— SeV
CITY Zip TELEPHONE
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PERMIT�EXPIRES
PERMIT
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PILAT NAMEISUDDIVISION NO, I LOT NO, 'L�D N
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COVERAGE REQUIRED SETBACKS (FT. PROPOSED SETBACKS (Fr.)
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GARAGE FETAININGWALL FIRE SPRINKLER
CARPORr L-J ROCKERY FIREALARM
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(TYPE OF USE BUSINESS OR ACTN ITY) EXPLAIN:
CHECKED BY ITYPE C 0 CUPANT �7
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NU BER CRITICAL A/A_
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OF DWELLING AREAS
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'ESORIBE WORK TO BE DONE
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REMARKS
PROGRESS INSPECTIONS PER UBC 1108YFINAL INSPECTION REO'D
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VA UATION
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Description FEE Description FEE
40 7-&, pr� CL� � rint
Plan Check
State Surcharge
HEATe GLAZING % LOT SLOPE %
Building Permit City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t� B DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURISS, SIDEWALKS, DRIVEWAYS MARQUEES, E7C.) WILL REQUIRE
2
Grading
PERM;
t: SEPARATE SSION.
Engr. Review
PERMIT APPILICANI N; He DAYS
PERMIL11111.11FAR-PROVID WORK IS STARTED WITHIN IBODAYS
0
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
En9r. Inspection
'APPLICANT ON BEHALF OF 1111 OR HER SPOUSE, HEIII SSIGNS AND SUCCESORS
Fire Review Plan Chk. Deposit
HOLA
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND D HARMLESS THE CITY OF
EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire InsPection Receipt #
ALL CLAlys FO DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
THIS NOT HE
FROM THE ISSUA CE OF THIS PERMIT ISSUANCE OF PERMIT SHALL
DEEMED To MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapolnusp. T.1al And. Due
0 NOR LIMIT IN ANY WAY THE CITYS ABILI IN TO ENFORCE ANY ORDINANCE PROVISION,
Recording Fee Receipt III
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE OULY AUTHORIZED AGENT OF
THE OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC*
CALL This applicager, lanot a earth until signed by Me
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LA
CEF THE STATE OF WASHINGTON RELATING TO
Building Official at his/her Deputy: and Fees are paid, and
FOR INSPECTION Ittesipi Is aclan-1,dBod in space snavidaulb
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W0rKMEWj COMPINSAT AND FICW 18.27.
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Om��SJIGN All
SIJ�7E�WNE E T) DATE SIGNED
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_4FENTION
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I 1 1 -ur.411i RELEASED BY' L_/ I DATE
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI-
ORIGINAL FILE - YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK.OWNER COLO-ASSESSOR
04/02 PRESS HARD -YOU ARE
MAKING 5 COPIES GREEN - ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Foatir i
Wall ............
Pier/Porch .................
Retaining W611 ...........
Slab Insulation
PLUMBING:
Underground ............
Rough -In ...........
Commercial Final
HEATING:
Gas Test
Gas Piping ...........
S "To, � P —L
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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