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EXPI
PERMIT RES
CITY OF EDMONDS
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PERM T
NUMBER
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CONSTRUCTION PERMIT APPLICATION
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NAME
NO 01 FIXTURES
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ADDRESS
REMARKS
72-0 T1111"t Ac-_' 23DO
OWNERICONTRACTOR RESPONSIBLE
FOR EROSION .11111I.I.M.W.E
ZIP
C"Yse,- 4_' 6 ) 8, lo 4-
Its,
C�k FIRE REVIEWED By DATE
VARIANCE OR cu SHORELINE OR ADB# INSPECTION NO
CHECKED BY a YREQ'D I PRO TED
LICENSE NUMBER EXPIR;2Tj OS
ES ONO
SERA REVIEW SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
EXP I I I
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS 0`0
NEW 103 LUMBING I MECH ALLOWED PROPOSED FRONT SIDE READ FRONT URSIDE REAR
�ESIGEHTI�
C MPLANCE OR
ADDITION CU I
CHANGE OF USE
PARKING I LOTAREA PLANNING REVIEWED BY
erREMODEL APARTMENT f SIGN REaD I PROVIDED
0 FENCE
13 REPAIR 0 GRADING CYDS X FT) REMARKS
DEMOLISH fj TANK 13 OTHER
[3 GARAGE o RETAINING WALL
CARPORT ROOKERY [3 RENEWAL
OWE OF USE, BUSINESS OR ACTIVITY) EXPUIN:
1
CHECKED BY ON CUPA:
4 C# G 0
GR CUP
NUMBER aITICAL r
OF READ SPECIAL INSPECTOR OCCU NT
JAREA
UMBE REQUIRED 0 YES LOAD
Inmdu�a R REQUIRE L
DESCRIBE WORK TO BE DONE
REMARKS
OGRESS INSPECTIONS PER UBC 10S/FINAL INSPECTION REO'D
New sk�3A,,"r— C
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Plan Check
OWING %
HEAT SOURCE LOT SLOPE %
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Building
PLAN CHECK N VESTED DATE
Plumbing
I TO,
LGrading
Mechanical
THIS PERMIT AUTHORM ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Ing
Recording Fee
3 DOMAIN (CUBBS, SIDEWALKS, DRIVEWAYS, MARQUESS, ETC.) WILL REQUIRE
t: SEPARATEPERMISSION.
Engr. Review
City Surcharge
PERMIT APPUCATION: INDAYS
-WITUNIft. I YEAR - PRONND 0 WORK IS STARTED WITHIN 180DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ANT,
'APPUO Oil BEHALF 01 HIS OR 11111 SPOUSE. IIEIRS, A11IG"1 AND SuCcEsms
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY. DEPEND AND HOLD HARMLESS THE CITY OF
ANY AND
Receipt #
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARIS114G DIRECTLY OR INDIRECTLY
Fire Review
t7
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FROM THE ISSUANCE OF THIS PERMIT. SSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAII E OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
Total Am OUITDue
0 NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
Landscapainsp.
Receipt #
HAVE READ THIS APPLICATION; THAT THE INFORMATION
1-.=_1.A.-.-R-.-fWTVA_.G THAT �
APPLICATION APPROVAL
A. THE OWNER, OR THE Duty A THORIZED AGENT OF
S
TH9OWNEFL I AGAiE TOTCHOAMTPLY WITH CRY AND STATE LAWS EGULATINGCONSTRUC�
CALL
This application is not, Tetnut until signed by line
TION� AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Sul head Official his/her Deputy; and face sca Paid, and
facelpt I—k—led,pul In space p—hod.
WORKMENS COMPENSATION 18.2.
OFFICIALS SIGNATURE DATE
(OWN ' AGElf DATE 6171)
(425)SIGNA"
771-0220
W4EW DATE
ATTEN
EXT 1333
L. A BUILDING OR STRUCTURE UNTIL
'Irg4"500;'w
771-0221
r"
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YE;I - INSFECTOIP(
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK-OWNER GOLD -ASSESSOR
10/01
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...............
FOUNDATION:
Footing .... ..................
wall....................
Pier/Porch . ................
Retaining Wall
Stab Insulation ..........
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PLUMBING:
0
Underground ..........
Rough -in ...................
-4
M
Commercial Final
HEATING:
0
Gas Test ....................
M
lTI
Gas Piping ............
Equipment .................
Commercial Final
EXTERIOR SHEATHING
n
NAILING .� ........................
MR11
FRAMING ............
FIRST FLOOR FRAMING..�
C ITI
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INSULATION
R1
Floor Insulation
Wall Insulation ..........
Ceiling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
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MISCEL LANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ...............