20020517.pdfDATE RECEIVED V , -1
It, I I PERMIT EXPIRES - ��122
USE PERM T -7
ZON LIM
CITY OF EDMONDS 6(1, N EIE R 909
CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT#
ADDRESS
&L0 6-p� a-e .-,
PLAT NAMEISUDDIVISION NO.
I LOT NO
LID NO,
LID FEE $
ve
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED—
um-
13
"a"PAV'REQUI-RED
L
ITILEPHONE
METER SIZE
LINE Sl!!��
I
YES 0 NO C3
z
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
M
CITY
mA42,% til I -Le
STATE LIC NSE NUMBER
APO LL N I'D
W,
NEW
PLUMIINGIM CH
0 PLUM 'ING 'MCH
ADDITION
COMMERCIAL
OMPLIA CE OR
COM PUANC' OR
El CHANGE OF USE
0 CHAN G OF USE
[3:1 REMODEL
0 MULTIFAMILY SIGN
11 SIGN
rl REPAIR
0 GRADING CyOS
IEN�-
X FT)
_ X
0 DEMOLISH
n TANK
OTHER
OTHER
GARAGE
g CARPORT
RETAININGWALL
ROOKERY
0 RRE SPRINKLER
r-1 FIFIESPRINKLER
LJ FIRE ALARM
I ALA
AS
ITYIV�SUI NEN 01 ACTRRnY) EXPLAIN:
NUMBER UMBER OF
OF -,,—I NELLING
o STORIES UNITS
DESCRIBE WORK TO BE DONE
L
ArJ It jlik� i
FIRE REVIEWED BY DATE
A
M
z
VARIANCE OR CU
SHORELINE OR ADS.
..No
1413IE�GTI.N
aE 6
POSTED
1,
YES ""
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
LOWED PROPOSED
ALLO ED PROPOSED
�Xp
1-7. 8
I
L4'
a rn
LOT C VERAGE
REQUIRED SETBACKS (Fr.)
PROPOSED SET BACKS IFTI
ALLOWED PROPOSED
FRONT SIDE BEAR
a SIDE REAR
'00
M
1
0
C:
PARKING I
LOT AREA
�5"o REVI
P D BY DAT"'/"
REaD PROVIDED
I0La
a,
rn
C,
REMARKS
0
CHECKED BY
CTI N
CODE
'PANT
JTY� �FTR
6��l
Rqup
ITI in
SPECIAL INSPECTION
OCCU NT
]AREA
REQUIRED [] YES
LOAD
C) 'I)
0 E_
0 9i
C
REMARKS
PROGRESS INSPECTIONS PIER UBC 1 SPECTION REOD
ad
C co
in 0
t)- _3 V0
VALUATION
THIS PERMITAUTHORIZES
$
1
1 z
Description
1
FEE
Description
FEE
1
65
Plan Check
[Plumbing
State Surcharge
z
HEAT SOURCE
LOT SLOPE
Building Permit
6—
;7
City Surcharge
9
PLAN CHECK NO:,, Z31LC�
1 11111 DATE
0
In
Mechanical
ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON I LIC
2 HE PUB
G ranting
DOMAJIN (CURBS. SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATEPERMI SSION,
Engr. Review
PERUIRTAPPLICATION: IN DAYS
PERMITUM I YEAR -PROVIDED WORK IS STARTED WIT14IN 'NDAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
r
'APPLI 'ANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Pl.�011ILD.p.Sit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLE S THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, AND
EMPLOYEES, AGENTS FROM ANYAND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt IF
FROM THE ISSUANC OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY,
Landscapeinsp.
Total Amt. Due
WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINA CE
x NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
—
Recording Fee
Receipt #
L
Ea_a
,/GHEREDY ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
APPR
IVE IS CORRECT, AND THAT AM THE OWNER, OR THE DULY AUT14ORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
CALL
I IPPI%11111 1�1� A 111.1—fil awned e, the
To IV AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL DE EMPLOYED
IN VIOLATION OF THE LABOR 0 E OF THE STAT 0 WASHINGTON RELATING TO
F
FOR INSPECTION
i1ronerdn'n, a D.Puly: and Fee, a,. paid. and
ud� 'aaefinj_k �Id'o.dj..P ... pnd�ld,d,
NCE AND CW 18.27.
Sill ATUIJ low
DATE
(425111
n�l
2R
At
771-MO
ATtENTION
111FIEASED
E)ff 1333
BY DATE
Wl
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
L
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELL
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKINIG 5 COPIES GREEN - ACCOUNTING
FINAL PROJECT APPROVAL FORM
TO:
DATOWO-e--
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE-
GINEERING DIVISION DATE -
z
PLANNING DIVISION DATE-�2�- O�
PROJEC T
fO
am
MO
0
SITEADDRESS
80
C
PERMIT ADB# DATE INSPECTED-
m
mz
(Sig 0
0-4
a
>
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine final compliance with approved plans. Final approval
0 -n
denotes that there are no objections from the above signed Department to the release of
n
PERFORMANCE BONDS and the granting of:
m m
0
GRANT FINAL PROJECT APPROVAL
0 M
C cl)
M 0
Z
z
GRANT PROJECT APPROVAL WITTI CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractorby inspector
C0
z
0
-4
0
m
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
o Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE-INSPFcTED, OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Si
ocaprvl.doc.l:temp:bldg:fonnsIO/OI
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
..........................
zWall
Pier/Porch .................
0
Retaining Wall ...........
Slab Insulation ..........
=i 9
PLUMBING:
M
C:
Underground .............
M
0
0
C
Rough -In
m
Commercial Final
IT! z
HEATING:
Gas Test ....................
Gas Piping .................
n
Equipment ............
M M
Commercial Final
EXTERIOR SHEATHING
NAILING ................
C (j)
C (a
I
IT! C)
FRAMING ........................
FIRST FLOOR FRAMING
;U
INSULATION ...................
z
Floor Insulation
Wall Insulation ...........
0)
z
Calling Insulation
0
SHEETROCK NAILING
ITI
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ...............