20020427.pdfDATE RECEIVED
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PERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT
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CONSTRUCTION PERMIT APPLICATION
—NUMBER
JOB ESS SUIT AITI-
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ADDR
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LA LID No
PLAT NAMEISUBDIVISION NO, LOT NO, U No�
MAILING ADDRtSS
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OWNERICONTRACTOR RESPONSIBLE FOR EROSION CON ROL/DRAINAGE
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NAME
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ADDRESS ':� s:u'
STATE LICENSE NUMBER E�FIPAH?NDATE Y
FIRE REVIEWED BY
DATE
VARIANCE OR CU
SHORELINE GRABS'
INSPECTION
BOND
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REG'
POSTED
13YES 'to
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGRT
ALLOWED PROPOSED
_XP
LOT COVERAGE
REQUIRED SET KS IFT.)
PROPOSED SETBACKS (Fr.)
7.-
[3 NEW 0 RESIDENTIAL 0 PLUMBING I MECH ALLOWED PROPOSED FRONT SIDE HEAR FRONT URSIDE FEAR :f
2 0 he
0 ADDITION )S] COMMERCIAL 0 COMPLIANCE OR /\A�' 4-#A 2 C
CHANGE OF USE IT
PARKING I LOT AREA I PLANNI�G REVIEWED By DATE 0
REMODEL
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0 TANK
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(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
TYP
NUMBER
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CRITICAL
OF
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DWELLING
UNITS
AREAS R
NUMBER
S ECIAL INSbPECTOI
REOUIREDO YES
It
DESCRIBE WORK TO BE DONE
REMARKS
ROGRESS INS
P in
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VALUATION $
VALUATION $
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BIG Pit
7.ATEL
FISH Check
Plan Check
GLAZING % LOT SLOPE %
LOT %
ED
Building
Building
PLAN CHECK NO: IS TED
Plumbing
Plumbing
Mechanical
a on I
THIS PERMIT AUT DBMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DOME ON PRIVATE PROPERTV ONLY. ANY CONSTRUMION ON THE PUSUC
ad n'
Grading
2
,, DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
t: SEPARATE PERMISSION, —
Kancal.
R.Vew
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PERMITAPPLICATI H: 1800AYS
PERMIT LUMM I YEAR - PROVID D WORK IS STARTED WITHIN I-- DAYS
C_ — —
In.,. DO.
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Tira"'.
IN INTEREST, AGREES T INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS ISO. ANY AND
Fire Review
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCi OF THIS PERMIT SHALL NOT BE
— —
Fire inspection
DEEMIG TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
ORD! AIX' PROVISION -
N NY N
OR LIMIT IN ANY WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION
Landscapoinsp.
-FILIATION
I FISHERY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: T:HATTHE INFORMATION
AGENT OF
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
.NST.U.
THE OWN9 . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
.,Loy
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
OF THE STAT OF WASHINGTON REILATING TO
I
FOR INSPECTION
U NCEANDACW18.27.
T G
a A ED
(425)
771-0220
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 CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
10101
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Description
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City Surcharge
State Surcharge
Plan Chk Deposit
Receipt #
Total A U t Do
APPILICATION APPROVAL
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P . E. : GOLD - ASSESSOR
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...............
FOUNDATION:
Fooling ......................
Wall ..........................
Pier/Porch .................
z
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
M
M
0
Hough -in ...................
6
0 C
Commercial Final
C L
HEATING:
M
10
Gas I set ....................
%
C
>
Gas Piping ...........
Equipment .................
0
Commercial Final
M ITI
EXTERIOR SHEATHING
0
NAILING ..........................
FRAMING ..............
ITI 0
FIRST FLOOR FRAMING
�z
-4
INSULATION ..........
Floor Insulation
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Wall Insulation
Ceiling Insulation
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SHEETROCK NAILING
0
SPECIAL INSPECTION
ITI
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY
...............
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