20020569.pdfDATE RECEIVED
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PERMIT EXPIRES
CITY OF EDMONDS
USE
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PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
F=OWNERNAME/NAME
JOB
ADDRESS
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIORAINAGE
CITY ZIP TELEPHONE
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NAME
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ENGINEERING REVIEWED BY DATE
ADDRESS
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FIRE REVIEWED BY DATE
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STATE LICENSE NUMBER EXPIRATION DATE
VARIANCE OR cu SHOSELINEORADBI INIPICTIO F BOND
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NT PAID
SEPA REVIEW SIGN AREA 1 EIGHT
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
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LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fo
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REMODEL SIGN
PARKING LOT AREA PLANNING REVIMED BY DATE
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EPAIR 0 GRADING o FENCE
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REMARKS
DEMOLISH TANK OTHER
GARAGE R
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A PORT E 'IREALARM
ROCKIERY F RESPRINK].
(TYPE OF USE. BUSINESS O!rFjrN!
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CHECKEDBY CCUPANT
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NUMBER OF CRITIC L
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ITYPEOFU
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P.MALINSPECTION OCCUPANT
UNITS N MISER
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REQUIRED [] yes LOAD
DESCRIBE WORK TO BE DONE
REMARKS is
PROGRESS INSPECTIONS PER USC 1011/FINAL INSPECTION REOD
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VALUATION
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ED FEE Dia;CrIption FEE
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State Surcharge
5
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ilding Permit
City Surcharge
PLAN CHECK NO: 7ED D�TE
Plumbing
THIS PERMIT AUTHORIZES ONLY THE WORK NOTEM THIS PERMIT COVERS WORK TO
Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU LIC
OMANN
Grading
(CURBS, SIDEWALKS, DRIVEWAYS E
SEPARATEPERM; MARQUEES, ETC.) WILL REQUIR
SSION.
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Engr. Review
PERMIT APPLICATION: IN DAYS
PERMIT LNAM I .. - I..I. ED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF F HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review P�an Go
IN INTER ST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Z EDMONDS,WASHIN ON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND
GT
_ _�.Deposhl
Fire Inspection Receipt
AL L CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMll ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY City ORDINANCE
1-andscape Insp. Total Amt. Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
Recording Fee Receipt III r7fj7_GZ.
I HEREBY ACKNOWLE BE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, 08 THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
Thia.PPfl..d.. Is not . p.-K Alil alg�ad by the
CALL
TION; AND IN DOING THE WORK ET.E.E.1 N ISRS.N WILL BE EMPLOYED
1. VIOLATION OF THE STATE OF WASHINGTON
Eflog"Offid'i or bloilp" D'P'ty� sed roes ,a paid, ead
RELATING TO
WORKMEN'S COMPENS IN LICE D RCvV 18.27,
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FOR INSPECTION 'elpt Is acknowledged I. space P-1dod.
__ - __ — — —
SIGN:2LRJ.� SIGNED
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(425)
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7, 1 -Mv PEASED BY
ATTENTION
EXT 1333
IT IS 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
OR�GINAL FILE - YELLOW � INSPECTOR
04/02 PRESS HARD -YOU ARE
PNK-OWNVR - G LD,ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ................
wait..................
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Pier/Porch .................
Retaining Wall
Slab Insulation ..........
PLUMBING:
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Underground .............
0
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0
Rough -in ...................
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Commercial Final
m
10
HEATING:
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Gas Test ...........
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Gas Piping .........
Equipment ...........
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Commercial Final
0
0
EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ........................
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FIRST FLOOR FRAMING...
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INSULATION ...........
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Floor Insulation
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Wall Insulation ...........
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Ceiling Insulation
0
4
SHEETR06K NAILING
0
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
No ACUCT
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