20020588.pdfDATE RECEIVED
9
PEE R:M�T E �XP I R E S�
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
O�NER NAMEINAME OF BUS
USE
ZONE PERMIT
NUMBER
JOB
ADDRESS IUITIIAITI
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PLAT NAMEISUBDIVISION
NO. LOT NO, I'D NO,
MAILING ADDRESS
0 12- �V- --7,7,, 14,,e
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP LID FEE S
ZIP TELEPHONE
q2S- 7
s-, .. F.R. need
EXISTING — PROPOSED— In --nn— 0
REQUIRED DEDICATION— Ft — U'
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I SIZE LINE SI PRV REQUIRED
ADDRESS
I
YE-x� No 0
REMARKS
OWNER/CONTRACTON RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP
TELEPHONE
NAME
ENGINEERING REVIEWED BY DATE
D'IT'y....
z
ZIP
TELEPHONE
FIRE REVIEWED BY DATE
STATE,UCENSE NUMBER EXPIRATION
77
KED BY
VARIANCEORCU
I SHORELINEORAOBN
INSPECTION
HE 10
oves, 13NO
BOND
POSTED
$
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PROPERTY OUNT P IT
a_ We�&
SERA REVIEW
COMPLETE , EXEMPT
ALLOWED PROPOSED ALLOWED
HEIGHT
PROPOSED
EXP
es
ITT 0
0
M
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NEW OFIESMEWFIAL PLUMBING / MCCH
'T
E:] ADDITION COMPLIANCE On
11 COMMERCIAL CHANGE OF USE
EMO
R DEL MULTIFAMILY SIGN
L.-
LOT C OVERAGE
ALLOWED PROPOSED
Re
REQUI- D SETBACKS (Fr.) PROPOS
FRO RF�Arl I
NT SIDE FRONT
D SETBACKS (Fr.)
UR SIDE BEAR
PARKING
REIVII PROVIDED
LOT AREA
PLANNING REVIEWED BY DATE
FE CE
REPAIR GRADING CYDS ri
( — A_'0
n DEMOLISH TANK ri OTHER
-
ca
REMARKS
GA�IA.GEIT RETAININGINALL
CA ROCKS cl F RE SPRINKLER
Ay FIRE ALARM
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(TYPE OF US'..Ss OR AGFVr_M E. :
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NUMB A I
OF
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NUMBER OF
DWELLING
U NITS
RITICAL
AREAS
C IVI�
NUMBER
SP CIALINSPECTION
REGUIRED
[] YES
AREA
AREA
OCCU PANT
LOAD
DESCRIBE WORK TO BE DONE
1 tv*
REMARKS
MNARK.
....... N.PECT..N. P.
ROGRESS INSPECTIONS PER UBC IOG/FINAL INSPECTION REOiD
[11A
WLY
Ittelk)
AFT'T.
VALUATION
$
CA
z
9
0
1711
16
Description
FEE
Description
FEE
$F —
SOURCE ING %
Plan Check
State urcharge
0,56
9-M
LOT SLOPE %
Building Permit
City Surcharge
LA CHECK NO:
VESTED DATE
Plumbing
- -
THIS PERMIT AUTHORIZES ONLY T E
BE DONE 0. PRIVATE P..P.A'.'.0LRK NOT 0. THIS PERMIT COVERS WORK TO
A. CONSTRUCTION
Mechanical
Grading
N
3
t:
. ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS MAROU
SEAAawrEPEnMi SSHIN, EEO, ETC.) WILL R - UIRE
Engr. Review
2—
-
PERMIT APPLICATION: ISODAYS
PERMIT LIMIn I YEAR � PROVIDED WORK IS STAITIED WITHIN 1.11 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
'APPLICANT. ON BEHALF OF HI OR HER SPOUSE* HEIRIL, ASSIGNS AND SUQ0E8ORS
IN INTEREST, AGREES TO INDSEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON' ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, AR 'SING DIRECTLY OR INDIRECTLY
FROM THEISSUANCE OF THIS PERMIT. I
DEEMED To MODIFY, SGUANCE OF THIS PERMIT SHALL NOT BE
WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Cl
NOR LIMIT IN ANY WAY THE WS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
Fire Review
—
Fire Inspection
Landscapeinsp.
Plan Chk Deposit
Receipt #
Total Amt. Due
LI HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN " COR'ECT,'ANO THAT I A. THE WlJEF. On 'HE U1 AUTHORIZE. AGENT .1
THE OWNS I AGREE To COMPLY WIT" CITY
ION; AND IN DOING THE WORK AND STATE LAWS REGULATING CONSTRUC.
T Ti.
IN N AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
I ViOLATIO LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN OM EN ION INSURANCE AND FICW IIL�7.
R rding Fee Receipt If
APPLICATION APPROVAL
In i.n.t. per
CALL ..Tilg 0"HPI, mit unlit signed by the
enter hhuh.1 O-P-tY: end Fldslb. Pled, end!
FOR INSPECTION I` Is Ackn011udge'd In elunn, Pd1ld0d.
a
SIGN _�.G .1 NED
(425)
771-0220
WLI 11111TURE E
g110
ATTENTION
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. USC SECTION 109
EXT 1333
DAT
ORGINAL-FILE YELLOW - INSPfCTOR
04102 P:NK-OWNER GOLD-ASSESSOP;
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
RECORD OF INSPECTIONS
I SPECTOR
N
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall
mer/Forch .................
R taining Wall ...........
Slab Insulation ..........
n"
PLUMBING:
0) -4
Underground .............
ITI
Rough -in ...............
C
Commercial Final
M
HEATING:
z
Gas Test ....................
Gas Piping ...............
_n
Equipment
-4
Commercial Final
ITI M
EXTERIOR SHEATHING
0
0 Fn
NAILING ..................
g-sa-V
C 0)
0)
ITI 0
FRAMING ........................
z
FIRST FLOOR FRAMING
vnt
INSULATION
Floor Insulation
z
-4
Wall Insulation ...........
0)
Ceiling Insulation
SHEETROCK NAILING
0
M
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
AMP 495 5 ZfP/