20020394.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
TELEPHONE
0 NEW
n RESIDENTIAL
El PLUMBING I MECH
AD Ac.
DITI.-
Comm
C IANCE OR
11
R REMODEL
EMODEL
HANGS OF USE
CO#APL
0 SIGN
REPAIR 0 GRADING CYOS
[3 FENCE
DEMOLISH TANK
0 OTHER
2
E
[3 GARAGRT RETAINING WALL
CARPO ROOKERY
—
U I ENEWAL
.. .. ....... _Ba OR ACTIVITY], EXPLAIN:
THIS PERMUTCOVER—
E-CK
'U
I*"11.`NToAZ9TGA, BEHALF OF HIS OR HER SIOUE�, HEIRs, ASSIGNS AND SUC,
DREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE
:1 EDMONDS IkASHINGTON, ITS OFFICRUS, EMPLOYEES AND AGENTS FROM A
IALL CLAIMiI FOR DAMAGES OFWHATEVER NATURE ARiSING DIRECTLY OR INDI
9 FROM TH - '_Z '
9 1 EM, ED ISSUANCE OF TH" PERMIT ia�6AN i OF THIS PERMIT $HALL i
1 11 T WAIVE 11. REIII, �
2 No,, LiMT, -or W YT. A RE CITY ORD
N A. F
JOB
jo
ADDRES SUITEIAPT#
A"R'S
PLO NAME]SURDIVISION NO.
LOT Nwo,--
No.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
a
EXISTING
EXISTING � PROP
r 7P.-POSED—
REQUIRED DEDICATION—
R
LINE SIZE
NO. OF FIXTURES
PAV AEOUJR��'
YES E3 NO
I
REMARKS
0 OWN RQGN. To. R F Naraie ca Erio�,. C.NTR,
WNERICONMA.TOR RESPONSIBLE FOR EROSION CONTROLIDMINAGE
ENGINEERING REVIEWEDIDATE
FIRE REVIEWED BY DATE
r
VARIANCE OR CU
HOREUNE OR ADS#
INSPECTION
BOND
'N-
REX
JZ-
13 YES No
IPOSTED
C $EPA REVIEW
OMPLETE EXEMPT
ALLOWED �R POSED
'HEIGHT
ALLOWED PROPOSED
XP
LOT COVERAGE
ALLOWED
REQUIRED SET ACKS (FT) PROPOSED
SETBACKS (FT)
PROPOSED
FRO SID REAR FPNL-
-StDe-,flaAR'
NO Cl A v� .-C, q,
1 fit
PARKING
OB
FIE 11. PROVIDE
PROVIDED
LOT AREA
NNING REVIEWED By DOE
.EMAR
-ILq 0�rTgQ -1 - 2� I)
IS CTION c TE 0 CUPANT
GROUP
4&
CCU NT
LOAD
< 10
EMARKS
PR BESS INSPECTIONS PER UBC 11081FINAL I ECTION REaD
VALUATION $
—
—
ascription
FEE
FEE
Plan Check .31,74
Building
.,e
Plumbing
Mechanical
.-�rading
Recording Fee
EngL Review
City Surcharge
Engr. Inspection
State Surcharge
Traffic Mitigation
an Chk Deposit
Fire Review
Receipt #
__pection
[fro Ins
Total Amou tD
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL r-A 1 113.3.3
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI_ 771-0221 lldloiv,,� I, S12�,
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL -FILE t,:3ELLOW. INSPECTOR
FAX PINK - OWNER - GOLD - ASSESSOR
z
0
0
M
C:
M
0
0
C
M m
Z
0
m M
- co
0 r-
OM
C
To
z
i!
ri)
z
9 1
0
m
vwIT 10 44116coa F46,4z
ZP(vS-wU(vG A08A (-Ty?)
?AbposaD Wirop
�yj
0
fs- Q M Irio
u psimps
t�gtLlWr Ckc--S
\00
1 73
r4
Ct
65
-Z-7 rn
0 C
m
4
m m
Z:
C co
IS A4—
NOT" "o mov Aicyto
IrISA
e�Q -S T7A) (c, -e
ctcl. I
t
w ov_r
ui BY PLANNING
us Ro lit 'b- 1"6 W REC EIVED
65 a:
f,7 �,,, , (�, tr MAY 13 2092
"
BUILDING DEPT.
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...................
FOUNDATION:
Footing ......................
wait ..............
PierlPorch .................
Retaining Wall ...........
Stab Insulation ..........
O�
PLUMBING:
Underground .............
M,
Sough -In ..................
IT1
0
Commercial Final
0
C
HEATING:
M
Mz
Gas Test
....................
Gas Piping ...............
Equipment ...........
0,n
Commercial Final
M,
EXTERIOR SHEATHING
GAS P
�4�1
M
0
NAILING ..........................
0 Fn
FRAMING
ISD
(j)
..........
4(94, I2-f7'Z
Cl)
M 0
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
z
Coiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
IT
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ............
f
01,04 f4OV
I