20020509A.pdfDATE RECEIVED '
%L PERMIT EXPIRES
USE PERMIT
CITY OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPTs
ADDRESS 17927 75th Pl W
IEfl NAMEMAME OF BUSINESS
Katrina Gerry PLAT NAME/SUBDIVISION NO. I LOT N0. 1I11 NO,
ING ADDRESS LID FEE S
17927 7 5th PI W PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP W v rm n.pwed
¢Mn
ZIP TELEPHONE EXISTING,�...ppOpGSgp--�^^^
SWewalkP q Ire¢
Edmonds 98026 425-741-8620 REOUIHE °� o �VmIt-caunect waeare Iga
E METER SI Ere4UTVEi1gIR f eIN i VWA1 AjJ 1 nl
-_ 1.....i A en_ Pc- i TMC 811.013 NO
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u
CITM . _
ZIP
Kirkland 98034
STATE LICENSE NUMBER
FASTWHC052DF
PROPERTY TN( ACCOUNT PARCEL NO.
473700002300
TELEPHONE
425-814-3124
EXPIRATION BATE C BY
2-16-03
FIRE R EWEO BY
VARIAN
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BE flEyL�y�
COMPILE 2A'EY.'
-XP P QUIT¢
NEW s� RESIDENTIAL
® PLUMBING i MECH
LOT
ALLOWS
IJ ADDITION oCOMMERCIAL
❑ CHANGE OF USE
13 REMODEL ❑ APARTMENT
SIGN
REQ'DAING I 1ROVIB-E1
''
REPAIR GMOING CYDS `ENCE . X F1)
REMARKS FFPI
DEMOLISH TANK
El
OTHERGARAGE
1
r� ^0
(.J CARPORT 1: ft CKERYG WALL
0 RENEWAL
(TYPE OF USE, BUSINESS OR A„ g fV
.CRITICAL
AREAS //,� /y,'y/�iONUMBER
l V('�jDESCRIBE
ffREMARKS
WORK TO BE DONE
Remove re lace as
water heater
in aaraae�Tn stand 40.000 btu's
I
of WhFowr ,Lie
LOT AREA PLANNING REVIEWED BY DATE
SUANT rO ECDC 19.30.020
S1 T ]IF, INsTALLED NEAR
THE WATER SHUTOFF
PURSUANT TO
GHALL DE INSTAL
LINT AS IT ENTERS
VALUATION $ �g
De icrin9lon I FEEi
OCCUPANT
LOAD
ON THE
PLAN CHECK NC:
VESTED OAT.
Plumbing
r_
Mechanic.,
t
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORKTO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ONTHE PUBLIC
Grading
Recording Fee
DOMAIN(CURIES,SIDEWALKS,DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATEPERMISSION.
Is
Engr. Review
City Surcharge
15,
�j
PERMIT APPLICATION: IN DAYS
PERMIT LIMnt 1 YEAR• PROVIDED WORK IS STARTED WITHIN 100 DAYS
EngL inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICAti I ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMION.DN. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
9
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
OEEMEDTOMODIFY, OFOR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
Total Amount Due
O2
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
„o�.��.
Landscape insp.
Receipt #
2nhQ
GIVENS ACKNOWLEDGE
COR CT; AND THAT I AM THE OWNER. OR AD THIS APPLICATION:
SEUTINFORMATIONT THE DU Y AHOfl 2 DAGENT OF
APPLICATION APPROVA
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
"
CALL
This ¢ppllpatlon Is- a p—It unfil signsd by Ih¢
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED8011fti;
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Oliiciolor his/her DopVly: and Foss—p¢Id,
rec¢Ipl is¢cknowlodged In spoco provided.
WORKMEIVS COMPENSAR 'U NCE AND RCW 18.27.
OFFICIALS SIGNATURE DATE
SIGNATURE (OWNER j1
OATS SIGNED
�a2/��>�S
^' � n
RELEASED BY E
ATTENTION
EXT 1333
IT IS U14LAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
%i1'OZ21
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELLOW INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER GOLD -ASSESSOR
10101
1
RECORD OF INSPECTIONS
G
. -
INSPECTOR
DATE APPROVED
- F
.
-:. SETBACKS ....................
i.'.
FOUNDATION:
'i
Footing ....::L•
- S
wall ..:... .. .....:
Pier/Porch:.. .......
Retaining Wall
• Slab Insulation .......,,
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O
>
M
-1 n-
- j
PLUMBING:
p C,.
Underground ... .::::.
-•I.IT
RI
mz
.. i
Rough -in
p ^i
Commercial Final ,,:...
..
HEATING:
ca
I
O"n
... Gas. Test
<.
j
S M
Gas Piping ....:......
..
R1 R1'
Equipment .....
n p- t
Commercial Final .::...,
C
1
EXTERIOR SHEATHING
-
'
NAILING ...........................
b.
"
... FRAMING ....
FIRST. FLOOR FRAMING...
Z
INSULATION ...................
Floor Insulation
—
O
Wall insulation ......
i
Ceiling Insulation ....
I'D'
'I
1
SHEETROCK NAILING ...
-
..
SPECIAL INSPECTION
j
MISCELLANEOUS ..........
FINAL APPROVAL FOR
Z
OCCUPANCY .
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