20020422.pdfI I PERMIT EXPIRES z
DATE RECEIVED a �1
... PER' T
CITY OF EDMONDS M
.
CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT#
ER HA ADDRESS
ING ADDRESS Ess IV PLAT NAMEISUDDIVISION NO. I LOT NO. US NO.
LID FEE It
PUBLIC RIGHT OF WAY PER OFFICIAL STREET Al
L;A� OL R. 1 rl
EXISHNf_. l"', "' p—,
IN or L (Iijt conne to'P.,_,J
ds ifio�, ��E —5 EQUIHIOUN&TIW
4.P=r.
"0 WIT, bliew"If -Ilitfmoymfi�#"v an IF
9
RESPONSIBLE FOR
All
fn,;UStRjV11VED1DATE
TY
FIRE REVIEWED BY
DATE
0
STATE LICE E 1P
Ell
Y
VARIANCE OR CU
SHORELINE OR ADB# INS.PEE.r�ION -OND'
S 0
E3YES E3NO
.ETE1
ROPE rTAx=
P 0, !ACCI,
SERA REVIEW
COMPLETE EXEMPT
—SIGN AREA
ALLOW111 PROPOSED
HEIGHT
ALLOVIIII PROPOSED
0 WO
0
EXP I
,
HE
Bs..E.Tl-
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED
SETBACKS (Fr.)
LU-SIAN:C16
ALLOWED PROPOSED
FRONT SIDE BEAR
FRONT L/RSIDE REAR
E3 ADDITION
COMMERCIAL
C MPL
CHANGE OF USE
0 REMODEL
APARTMENT
0 SIGN
PARKING
RECrD
I
PIOVIGIG
LOT AREA
I PLANNING REVIEWED BY DATE
REPAIR
[j GRADING F Nos
—
I
( — X Fr)
REMARKS
DEMOLISH
0 TANK
OTHER
1 CA AD
1 11 E
ARP.IIT
RETAINING
11 ROOKERY WALL
RENEWAL
UWE OF USE, BUSINESS OR
C14ECKED BY
ITYIMIITN
:M.00CUPANTg:3
F
NUMBER
ROUP
OF
SPECIAL INSPECTOR
on
STORIES
JAIIIA
REQUIRED 0 YES
ILOAD
DESCRIBE WORK TO BE
DONE
I
REMARKS
PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REOID
1�1./ IJUJ,/ lj//Jff/f,�
Description
FEE
Description
FEE
/ 0—
Plan Check
Or SLOPE
Z;BKOUICE
Building
PLBWGL4E
cp�w�
Plumbing
THIS PERMIT AUTHORIZES ONLY THE W7RK NOTED. THIS PERMIT COVERS WORK TO
—
Mechanical
4L
t: BE DONE ON PRIVATE PROPERITY.N11. CONSTRUCT
x ION ON THE PUBLIC
DOMAIN '
Grading
Recording Fee
(CURBS, SIDEWALKS. DRIVEWAYS E ) WILL REQUIRE
SEPARATEPERM11MAGNU E`FTC
Engr. Review
City Surcharge
En ON
P MffAPPUCATI '" DAYS
PERMIT UMrP I YEAR- PROVIDED WOR ISSTARTEDWITHIN INDAYS
Engr. Inspection
State Surcharge
SEEBACKOFPINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTERIST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON IS 0 FICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
AUCLAIMSFOROAMAGEsof'WHATEVE NATURE ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMITR ISSUANCE OF THIS EAMIT $HALL NOT BE
P
D EMED TO MODIFY,
Fire Inspection
Total Amount Due L,
WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
I
Landscapoinsp.1
I HEREBY ACKNOWLEOG THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OMER,
APPLICATION APPROVAL
OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I ABBE E 0 PLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
Thl� p—H-0 Ipi,d by tti.
TION, AND' WcallLAUTEl"I'l.1111ED THEREBY, NO "RION WILL BE EMPLOYED
uJ1o,IgOf0d.I.,h h., p.y:.d1F2PW0,�,,d
N "._T 0 OF OF THE STAT OF WASHINGTON RELATING TO
EN) A IN E AND RCW 18.27�
W.rRIM C. pi;�
7
FORINSPEC TION
_.JpI N .1kn—I.dg.d p-Id.d.
WGNAT E W 0 A
I DATE """ED
(424�
OFFICIALS PIGNAtRE DATE
, Z��E
(ok7
WE
71 *_W� 0
EXT 1333
n ' OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL -FILE - YELLOW -INSPECTOR
10/01
FAX
PINK -OWNER - GOLD -ASSESSOR
f
z
0 lin
C
M
0 r
-4
3: M
M z
2:2
> z
r_�,
:�
0
"n
M M
U CO
0
0 Fn
C to
3: 0)
z
;j
vi
z
rR
RECORD OF INS PECTIONS
INSPECTOR DATE APPROVED
*SETBACKS ..................
FOUNDATION:
L
Footing......................
r
wall ...... . ...........
z
Pier/Porch .................
0
Retaining Wall ...........
0 "1
Slab Insulation ..........
PLUMBING:
Underground .............
M
C
M
-4 0
Sough -in ...................
0 0
Commercial Final
C:
-I C
M
M
HEATING:
C
Gas Test ....................
Gas Piping ................
0 'n
Equipment
Commercial, Final
ITI M
EXTERIOR SHEATHING
0
0
NAILING ................
C:
FRAMING ................
ITI 0
FIRST FLOOR FRAMING
z
INSULATION ...................
Floor Insulation ..........
z
Wall Insulation ...........
Ceiling Insulation
z
SHEETFIOCK NAILING
0
I'D
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .......... Non