20020547.pdfA�A DATE RECEIVE
EXPIRES
CITY OF EDMONDi
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CONSTRUCTION PERMIT APPLICATION
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METER SIZE P V REQUIRED
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FIRE REVIEWED BY DATE
STATE LICENSE NUMBER EXPIRATION 0
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VARIANCE OR CUI SHORELINE OR ADS# INS�P�E.0�10N I 'BON.D.
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SERA REVIEW SIGN AREA HEIGHT
EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
SCOMPLETE I
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.. ENTIAL
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS
PL UMIHN. I .1C.
ALLOWED PROPO D T SIDE REAR FRONT
"ON US SIDE AFAR
C MPLIANCE OR
• ADDITION COMMERCIAL CHANGE OF USE
— I
• REMODEL 0 APARTMENT 0 SIGN
PARKING LOT AS �A
REGO I PROVIDED DATE
O� �EP [3 GRADING o F NCE
— CYOS ( —X_Fr)
REMARKS
.... US. 11 TANK o OTHER
OGARAGE — RETAINING WALL 1711 RENEWAL
ARPORT U ROOKERY
CHICKEDBI
CCUPA
-NUMBER ----T
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—1pr;MKIRESS
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INSPECTIONS PER UBC 108/FINAL INSPECTIO
VALUATION $
FEE_
Description
Description
Plan Check
GUZDNQ I
HEAT SOURCE LOT SLOPE %
ul
Building
PLAN CHECK NO: STED DATE
Plumbing
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVER WORKTO
Mechanical
t: BE DONE ON PRIVATE PROPERTY ONLY. AMV CONSTRUCTION ONTHEPLIBUC
2 1) ETC. A
OMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, )WILL EQUIRE
Grading
Recording Fee
3
1: SEPAMTEPEAMISSION.
�ngr. Review
City Surcharge
PERMITAPPLICATION:180DA"
YEAR *1ROVID"DW MISSTANTEDWIMIN la..AYS
SEE .... F PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
State Surcharge
;APPUC W. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
N INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
—
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMrr. ISSUANCE OF THIS PERMIT SMALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE
Fire Inspection
Total Amount Due
ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION..
Landscapainsp.
--tGG-'P'
I
I HERESY ACKNOWLEDGE THAT I HAVE REM THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE DULY AUTP40RIZED AGENT OF
APPLICATION APPR OVAL
THE OWNER� IiAGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This.ppue.fta [a.., a peaft -nil signed by the
TION. AND IN DING THE WORK AUTHORIZED THEREBY NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR C�OO THE $TAT OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATO'BiNe NCE AND FIC. I&ZI,
ding Clacial'T his/ha, Deply: and Foos 8ta paid, and
FOR INSPECTION 1—ipt 11 ac,knoll.dg.d In.p.o. p—ided.
(425)
771"0220 RELEASED BY —DATE
ATTEMION
IT IS UNLAWFUL TO USE OR OCCUPY
M 1333
VAL
A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN
771-022
1 L —L7��
MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
ORIGINAL - FILE - YELL,
PINK - OWNER - GOLD - ASSESSOR
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FINAL PROJECT APPROVAL FO
TO:_
DATE: —
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: --FM DEPARTYMNT DATE —
EN GME RIN G D W I S ION D AT 13 tS 10
PLAISMG DIVISION DATE —
SITE ADDRESS!
5-10
1
PERmrr INSPECTED —ilu —
DESCRIPTION OF WORK TO BE INSPEC
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
PERFORMANCE BONDS and the granting of
X GRANT FINAL PROJECT APPROVAL
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GRAM PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
FARM FINAL INSPECTION - OUTSTANDING ISSUES
13 Copy of CORRECTION NOTICE given to owner/contractor by inspector
I
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date— Sign,
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
z
wait � .....................
PlerlPorch .................
Retaining Wall ...........
Slab Insulation ..........
R1
PLUMBING:
M 0
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Underground
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Rough -in ...................
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Commercial Final
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HEATING:
Gas Test ....................
0 _n
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Gas Piping ..............
M M
Equipment
0
0
0 IT,
Commercial Final
C: cl)
EXTERIOR SHEATHING
0
NAILING .............
FRAMING ........................
FIRST FLOOR FRAMING
Z,
INSULATION ...................
Floor Insulation
z
Wall Insulation
Ceiling Insulation
M
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ................