20020516.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
19015 - 92nd Avenue West
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ELSINORE
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Edmonds 98020 425-640-2534
PERMIT EXPI
USE
ZONE PERMIT
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JOB
ADDRESS 0 SUITE, IT
PILAT NAMFISUBDIVISION NO.
LID NO.
LID FEE
PUBLIC RIGHT OF WAY PER OIRCIAL STREET MAP
I-P A—- 0
EXIST�NG PROPOSED-
0
I- �ti A-111d 0
REOU RED DEDICATION- PT
0
METER SIZE
LINE I-
10, OF FIXTURES
PEOUIREO
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1
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0 NO 0
7EMARKS -
ILIIONIIILIFOIIROSIONCONTIOUD-INAGE
g,NERLC2,NTRACLO
NAME
NORDIC SERVICES, INC. CIPJAW)
ADDRESS
ENGINEEM G
REVIEWEDIDATE
9618 Midvale Avenue North
CITY -
FIRE REVIEWED BY
DATE
Seattle -9570
STATE LICENSE NUMBER EXPIRATION DATE HE El,
VARIANCE OR CU
SHORELINE 08 ADB� INSPECTION BOND-
NORDISI180QA 04
01/01/
0Y RE ID POSTED
ES ONO I
PROPERTY TAX ACCOUNT PARCEL NO,
CoM SERA REVIEW
PLETE EXEMPT
SIGN AREA HEIGH r
ALLOWED PROPOSED ALLOWED PROPOSED
00434600003006
-
Exp
2 R:SID:NTIA
New L 0 PLUMBING
LOT COVERAGE
REOUIRED SETBACKS R`t� PROPOSEUSE T'AC11 IFTI
MECH
ALLOWED PROPOSED
FRONT SIDE REAR FRONT UP BIDS FEAR
0 ADDITION C3 C . FIC 0 COMPIL ANCE OR
Al CHANGE OF USE
IM]
0 REMODEL APARTMENT
PARKING LOT
ARIA PLANNINGREV17=DBY _&A-TE-_
5
M SIGN
REGO PROVIDED
REPAIR C] GRADING FENCE
I
_qBMARKS
[3
CYDS ( _ X IT)
DEMOLISH 0 TANK 0 OTHER
GARAGE
CARPORT 0 RETAINING WALL
8 0 RENEWAL
QCKERY
r (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
single family residence/.1.
CHECKED BY TYR!.�nTA
U NUMBER UMBER I CAL
N o CRIT
OF DWELL NO A EAs
SPECIAL INSPECTOR OCCUPANT
STORIES UNITS NUMBER
JAHEA
NE.UREU YES
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
new trusses & framing for roof nel.Aj
PROGRES ECTIONS PER USC 108/FINAL INSPECTION REQ'D
3.
t-\ 0i 4t
VALUATION FEE
L7v
PLAN -CHECK'E.
HEAT .1zIN. I LOT SLOPE %
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:�6
- -
PLAN CHECK NO: VESTED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVER WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTR TION ON T E PUBLIC
DOMAIN iCURBS, SIDEWALKS, DRIVEWAYS, 1AROUE UC ETC.) WILLH
BE, REQU IRE
GRADINGIFILL
It SEPARATE PERMISSION.
TE SURCHARGE
BERMITAPPLICATI N
o DAYS
P. PERMIT LIMIT, I YEAR PROVIDED WO, K IS STARTED WITHIN 18G DAYS
_IT
ENG REVIEW FEES
SEE BACK 01� PINK PERMIT F OR MORE INFORMATION
'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESCRE
ERG. INSPECTION FEE
IEN I.N.TNIRE.SWT.AAGREGES TO �NIDEIANIII Bel NO AND HOLD HARMLESS THE CITY OF
E G. , ERIN TON, TI OFFICIALI* IMPLOYEEI, 111) AGENTS FRO. ANY AND
ALLCLAIMS FOR DAM-ESOB WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
LANDSCAPING
INSPECTION FEE
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
RECEIPT
DEEMED TO MODIFY. WAIVE OR REDUCE ANY AEOUIREMENT OFANY CITY ORDINANCE
0 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVIS10-
PLAN CHECK DEPOSIT
TOTALAMOUNTDUE IRICIIPT..g
q I
]HERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE MPORMAHON
GIVEN IS CORRECT, AND THAT $ AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
APPLiC ION APPROVAL
THE oWNFR.,])AGRE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
7THE
CALL
flON:ANDIN DING WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
OF THE
6 Id,,q 0(1.-10, ,$Iho, DIP'lly: a,,R1 F "I P,11d, ald
IN VIOLATION THE STATE OF WASHINGTON RELATING TO
CompENS$r 41CGR')A'No.E
FOR INSPECTION 11 ��'dgod P p,dId,
WORKMEP'S AND RCW 18,27.
SIG� R 0 DATE SIGNED
(425)
OF11 LS TUBE
�A'
07/08/02
WATE
771-0220
ENTION
EXT1333
RELfEAEDY DA
, 1
ITISUNLAWFULTO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL
771-0221
1
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing.......... ...........
wall ...............
Pier/Porch .................
Z'
Retaining Wall ...........
0
Slab Insulation ..........
PLUMBING:
q :H
Underground .............
am
C
Rough -In ...................
m
Commercial Final
C
HEATING:
x rn
M z
10-4
Gas Test ................
Gas Piping
z
.................
Equipmerit
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Commercial Final
m M
EXTERIOR SHEATHING
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NAILING ..........................
0
0 Fn
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FRAMING .........................
K Cl)
IT 0
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
z
Wall Insulation ...........
;C
Ceiling Insulation
z
SHEETROCK NAILING
SPECIAL INSPECTION
m
MISCELLANEOUS
FINAL APPROVAL FOR -ID
OCCUPANCY .................
A.
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