20020531.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
0�1 ME%1UIIN 11
MAILING ADDRESS
CIE.
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I � I
PERMIT EXPIRES _L1,'
us, PERMIT
2N. NUMBER W,
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ADDRESS SUITE/APTv","':'
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PLAT NAMEISUDDIVISIO N NO.
LOT No
LID NO.
LI. FEE
PUBLIC RIG14T OF WAY:FER OFFICIAL STREET MAP
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ina
an.. 'Re
EXISTING — PROPOSED —
UM
On,-1--eae 13
In We_,,ad 0
U-2-
13
REQUIRED DEDICATION— FT —
METER SIZE
WE SIZE
NO, OF FIXTURES
PRV REQUIRED
I
YES E3 NO C3 3
REMARKS
OWNERICONTRACTOR 0 ESPONSIBLE FOR EROSION CONTROLIDRAINAGE
I—
ADDRESS
111-,�bq 14o,e 91 �S��'r-mrr I CI
-CITY
N
" ENGINEERING REVIEWED By DATE
FIRE REVIEWED By DATE
ZIP -
TEL111IONE
L% -
STATE LICENSE NUMBER EXPIRATION
tDAT'
IS By
VARIANCE 08 CU SHOREUNEOIADBI I
INSPECTION
E3Y RE D
Es ONG
POSTED
Is BON
PRO_P_ERT_YTouW
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SIGN AREA
COMPLETE , EXEMPT, ALLOWED PROPOSED I ALLOWED
EXP
HEIGHT
, PROPOSED
NEW RESIDENTIAL 0 LUMBING I MECH
LOT COVERAGE :: REQUIRED SETBACKS (FT) PROPOSED
ALLOWED PROPOSED FRONT SIDE BEAR FRONT
SETBACKS (FT.)
URSIDE REAR
IT COMPL NCEOR
E] ADD ION rl COMMERCIAL M CHANGE OF USE
REa PARKING
0 1 PROVIDED
LOT AREA]
PLANNING REVIEWED BY DATE
r7 REMODEL MULTIFAMILY n SIGN
[j REPAIR E] GRADING FENCE
CYOS I X FT)
REMARKS
rl DEMOLISH 0 TANK
FIE
2 'A'A RETAINING WALL .1'RINKL�&
ARIGORT ROCKEAY FIREALARM
(TYPE OF USE, BUSINEPORIACT EXPLAIN:
&
"'C"D By
Go'
INUMBER
D OF
NUMBER OF
DWELL NO
CRITICAL
&4
I PEIL;'IAL�1.11 IF E.TIO N
OCCUPANT
STORIES
U NITS
A1.EA.
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UMBE
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REQUIRED [] YES
JAMEA
LOAD
DESCRIBE WORR TO BE SON.
r
Descriptlon
FEE
ADATI
Plan Check
OT�
X7UbCa
Building Permit
PLAN CHECK NO: VESTED
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
t: RED NEON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
a 'TC.)
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS QUEES, L WILL REQUIRE
t: SEPARATE PE R MISMSAI on N.
Engr. Review
PERMIT APPUCATION: 180 DAYS
FERMITLIM I YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF, HIS OR HER SPOUSE, HEIRS ASSIGNS AND SUCCESORS
Fire Review
IN INTEREST. AGREES TO NDEMNIFY� DEFEND AND HOLD HARMLESS THE CITY OF
2 1 MONDE, WASHINGTON, III OFFICIALS, EMPLOYEES, AND Al INTI F1 M ANY AID
0 G
Fire Inspection
ALL CLAIMS FO DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
1 FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MOCH WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY
Landscapeinsp.
, ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
I HERESY ACKNOW EDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGIEETO Co. D' WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
II.N; AND IN I'D G 'E AUTHERIIED THEREBY, NO PERSON WILL BE EMPLOYED
C.g
.-T ON OF T. OF THE STAT OF WASHINGTON ABLATING TO
Be
FOR INSPECTION
N!E Co. T �CE AND now RL27.
W4KME PE.�A
'g,
0 UBE (OWN R GENT) DATE SIGNED
(425)
OFF�
771-0220:
FELL
7FENT16W
E)ff 1333 :
IVS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
04102 PRESS HARD -YOU ARE MAKING 5 COPIE
Le
UBC 108/FINAL INSPECTION REITO
flkakblx�l—
j—&--iliptlon FEE
, iState Surcharge
_____ 1 4:
Receipt #
Total Amt. Due
I Receipt III 12-/)/b22
APPLICATION APPROVAL
Thia appli.eikei 1, net. pan.!, uned alge.d by Me
died Official,r ledinin Dajnuay� and Flea are paid, and
r ... irn 1, aIdA1KJg,d In ap— pre,jeled.
MIS SIGNATURE DATE
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ksel, BY T,
ORIGINAL RLE YELLOW-INSPECTOS
PINK -OWNER GOLD -ASSESSOR
GREEN ACCOUNTING
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0 M
C: 0
M 0
80
C:
R11 M
10
0
M M
0 6TI
C:
Q 0
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing .............
Wall..........................
Pier/Porch ...........
z
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
0
M
0
Rough -In ...................
0
c
Commercial Final
K
M
z
HEATING:
10-1
GasTest ....................
Gas Piping . ................
Equipment .................
x
Commercial Final
ITI ITI
EXTERIOR SHEATHING
0
NAILING ...............
n
C (0
F. ca
FRAMING ......................
M C)
FIRST FLOOR FRAMING
INSULATION ...................
-4
Floor Insulation
z
Wall Insulation ...........
fj)
Ceiling Insulation
z
SHEETROCK NAILING
SPECIAL INSPECTION
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ...............