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CITY OF EDMONDS ZONE PERMIT
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CONSTRUCTION PERMIT APPLICATION Jo UITE/AFT#
ADDRESS
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LENAMEL-A-MI�01
PLAT NAMEISUBDIVISION NO. 711. 1 NO.
.AILING ADDRESS D FEE
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NAME METER SIZE
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YES 13 NO 13
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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LOT COVERAGE REQUIRED SMACKS (Fr.) PROPOSED SETBACKS i
TIAL 0 PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIASIDE REAR)
.W PROPOSED
0 ADDITION L C MPLLANCE OR
CHANGE OF USE
PARKING LO� AREA REVIEWED 13Y OAT
GPUNNING
0 REMO DEL RE"O PROVIDED
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NUMBER OF CRITICAL
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WELLING AREASS PEC[AL IN OTOR
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N S NUMBE IiII)I "EQUIRED LOAD
0 STORIES YES
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECT16NS PER UBC 108/FINAL INSPECTION REGIO
VALUATION $
Description
�FEE Description FEE
Plan Check
HEAT SOURCE LOT SLOPE %
Building
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PLAN CHECK NO:
Plumbing
I
Mechanical
THIS PERMIT AUTHORIMS ONLY THE ORK NOTED. THIS PERMIT COVERS WORK TO
BE CONE ON PRIVATE PROPERTY ONLY. AM CONSTRUCTION ON THE PUBUC
2
Grading
Recording Fee
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMiSSION.
Engr. Review
City Surcharge
RE MITAPPLICATION: INDAYS
PERMIT LIMM. I YEAR PROVID 0 WORK IS STARTED
- WITHIN 1 00 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
State Surcharge
F His OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESURS
Traffic Mitigation
Plan Chk Deposit
IN—IN'T"E^AE"'SIT�-,A,G,R,EE—S"T INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
a EDMONDS, WASHINGTON, I OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CILAIMS FOR DAMAGES P.M. NATURE, ARISING .311ECTLY OR INDIRECTLY
Fire Review
Receipt #
FROM THE I SUANCE OF THIS PERMM ISSUANCE F THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY. WAIVE OR REDUCE A YREOUIREMENTOFANYCHNORDINANCE
Fire Inspection I
Total Amount Due
N OR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Landscape IRS P.
Receipt IV
I HERB ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVE IS CORRECT, AND THAT I AM THE OWNER. OR THE OULY AUTHORIZED AGENT OF
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APPLICATION APPROVAL
THE OWNER. I ABBE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
applie.0- 1-4 a peneaft-11 elga.d by Be.
TION; AND IN DING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPILOYEO
IN VIOLATIO A OF HE STATE OF WASHINGTON RELATING TO
suaTh',
dlln� Offid.1.11,1IV1,11 Depley: and Fee. arapald. and
FOR INSPECTION ... Ire I—kn7w].doed In ap.e. ra.Id.d.
WORKMEN'S WNE�TAI."Nol.�CUOI;.EA�.�CWI..�l.
00F1 SIGNATUR D
SIG A E W OR AGE I DATE SIGNED
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771 -0220
ItEXSED BY —1.
ATT,"TId N
EXT 1333
P" A R III DING OR STRUCTURE UNTIL
CERTIFI-
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
ORIGINAL - FILE YELLOW INS
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FRO V FIRE DEPARTMENT DAT
ENGINEERING DIVISION DATE—
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A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of:
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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u Copy of CORRECTION NOTICE given to owner/contractor by inspector
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RE_INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date_ Sip_
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing . .....................
Wall ..........................
6
Pier/Porch .............
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Retaining Wall ...........
Slab Insulation
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PLUMBING:
Underground
0 M
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Rough -in ...................
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HEATING:
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Gas Piping
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Equipment .................
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EXTER OR SHEATHING
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FRAMING ........................
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FIRST FLOOR FRAMING
INSULATION ...................
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Floor Insulation
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Wall Insulation ..........
Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY