20020551.pdf4 DATE RECEIVED
7 [Z PERMIT EXPIRES
USE PERMIT
CITY OF EDMONDS ZONE NUMBER 11?6
CONSTRUCTION PERMIT APPLICATION JOB
ADDRESS
VwNt" NAMh1NAME OF 8PSINESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Is
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STATE LICENSE NUMBER EXPIRATIO14 DATE I C R cu SHORELIh
W,"[AIXE
SEPA REVIEW
PROPERTY TAX ACCOUNT PARCEL NO, COMPLETE EXEMPTP1J*S0Ab
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P TIMENT
REMODEL A A. SIGN
r] REPAIR GRADING CYDS [3 (FENCE X FT)
DEMOLISH TANK OTHER
REMARKS
BE NSTALLED NEA-K
THE WARR SHUruirl-
o GARAGE [3 RETAINING WALL
CARPORT ROOKERY El RENEWAL
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(TYPE OF USE, BUSINESS OR IVnY) EXPUIN:
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CODE
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I ... PANT
GROUP
GROUP
INUMBER DNUMSER OF CRITICAL
OF WELLING EAS SPECIAL INSPECTOR
I U AR EQUIRED [] YES JAREA
0 STORIES NITS NUMBER [RREMI�1"
DESCRIBE WORK TO BE DONE (Lalsh7rl EMARKS
PROGRIES
I Re_'PL_Ptce_ 40 is operl or dom
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VAILUATION
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PlanChock
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PLAN CHECK NO: VESTED DATE
Plumbing
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410,
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THIS PERMIT AU`rHOFUZES ONLY THE ORK NOTED, THIS PERMIT COVERS WORKTO
t: 8 DONE ON PRIVATE PROPER" ONLY. ANY CONSTRUCTION ON E BLIC
2 -:211
Grading
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Recording Fee
(CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC) WJ_L RPU
:I CFO L EQUIRE
SEPARATEPERMISSION.
Engr, Review
City Surcharge
PERMrTAPPLICATION: INDAYS
T PERMIT LIM - I YEAR - PROVIDED WORK IS STARTED WITHIN 10 DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
—
Fire Review
Receipt #
ALL CLAIMS FO DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE I SUANCE OF TH S PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE REDUCE ANY REQUIREMENT
Fire Inspection
Total Amount Due
OR OF MY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE DRYS ABILITY TO ENFORCE ANY ORDINANCE PROWSIOM'
Landscapainsp.
Receipt #
1 HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT-, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER, I ABBE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This appl"sti.. I..— p-11 01 �Ignsd by ths
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR ASHINGTON RELATING 70
THE ITAT OF
S'ildlng Offid.1.1 hisibrID.PWY: and F-ar-
FOR INSPECTION Ipt Is ack—ledged 1, op—
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WORKnNIS COMPENS U. C1 AND HOW 11,27,
OFFICIALS S
DATE
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1 771-0220 -RELEASED BY
ATTENTION
Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGNAL-FRE - YE11—INSIECT..
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .......... ..........
FOUNDATION:
Fooling
Wall ......................
Pier/Porch .................
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Retaining Wall ..........
Stab Insulation,
PLUMBING:
Underground .............
3:
Rough -in
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0
0
HEATING:
C
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Gas Test ...............
Gas Piping
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.................
-4
Equipment ............
Comme miatrinal
EXTERIOR SHEATHING
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NAILING ..........................
0
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FRAMING ..� ...........
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FIRST.FLOOR FRAMING
M 0
INSULATION ...................
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Floor Insulation
Wall Insulation
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Ceiling Insulation
C4
SHEETROCK NAILING
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SPECIAL INSPECTION
ITI
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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OCCUPANCY ..................