20020621.pdfDATE HICIII Iq 1 .0_2, 14
PERMIT EXPIRES
PERMIT
CITY OF EDMONDS ZON NUMBER
CONSTRUCTION PERMIT APPLICATION JOB EBB SUITEIAPT#
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FLAT NAME/SUBDIVISION NO, I LOT 10, 11 0.
AILING Lit) FEE $
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Aq PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP mcp" d
11 Tel.
try ZIP ITELEPHONE EXIS ING PROPOSED— 'n'p"an'1
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REQUIRED DEDICATION— FT
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[AME I L S SIZE No. OF FIXTURES PRY RE UIRE
OGRESS 3EMARKS I _ I I YESO NO E3
—1.1,1—LE FOR EROSION CONTROL/DRAINAGE
BY
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FIRE REVIEWED BY DATE 1.
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STATE UdENSE NUMB R X, ��T
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SEPA REVIEW
GO MPLETE I I
EXP
SIGN AREA
ALLOWED , PROPOSED
HEIGHT
ALL ED
PIT
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rl NEW 0 PLUMBING/MECH
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (FT.)
FRONT SIDE HEAR
PROPOSED SETBACK$ (Fr.)
FRONT LOT SIDE R
-OR
COMPLIA CE OR
ADDITION 0 CHANGEOFUSE
REMODEL El 'IGN
REPAIR GRADING CYOS 'W�NCE
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LOT AREA
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REMARKS
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o GARAGE STAIN F ESPRINKLER
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9 CA PORT ROCKERY FIRE
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TYPE OF USE, BUSINESS O��MIN;
CHECKED B!��CTION
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UMBER OF
WELLING
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CRITICAL
A EAS
NUMBER
SPECIALINSPE JARIA
REQUIRED [3ey"EGN
OCCUPANT
LOAD
DESCRIBE WORK TO BE DONE
REMARKS is
P OGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION IREO'D
V ALUAT'ON
VALUATION
$
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Description
FEE
Description
FEE
2.&42CO)
F,
Plan Check
State Surcharge
HEAT SOURCE LOT SLOPE %
Building Permit
u" g Permit 717U
4—)
Cit, Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THEW RKNOTED. THIS PERMIT COVERS WORKTO
t; 0 DONE ON PRIVATE PROPERTY ONIM ANY CONSTRUCTION ON THE PUBLIC
Grading
W REG
3 DOMAIN (CURBS, SIDEWALKS,011RIMAYS, MARQUEES, ETC.) ILL UIRE
SEPARATE PERMISSION. —
Engr. Revie.
PE MITAPPLICATION: ISOIDAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK Of PINK PERMIT FOR MORE INFORMATION
IPPLIOANT. ON BEHALF 01 HIS 01 HER SPOUSE. HEIRSA SIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY DEFEND AND HO DTHMILESS THE CITY OF
EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt 0
ALL CLAIMS FOR DAMAGES 0 WHAT�ER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE
DEEMED TO MODIFY, WAIVE OR RED CE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscap:.=Insp
Total Amt. Due
I
0 PROVISION..
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE
—
Recording Fee
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGRE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONST RUC'
CALL
pernal ndil signed by Me
g ban 1,,sba�
Llic2
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
_ Ga
"r, spiny: and Fees are paid. and
IN VIOLATION OF THE LASOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTIOI receipt 1, ackTLwndg,d Insp," jnwid,d.
WORKMEN'S 5qj$UNSATION INSURANCE AND RCW 18.27.
07
SICNATUR<(,OM_N E SIGNED
'fiK Dw
(425)
ZXL�— I
771-0220
RRE—ASEDBY
A "E ION
EXT 1333
� . 1 11 " __ OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. LED SECTION 109
INK - OWNER - GOLD . ASS SSOR
04/02 PRESS HARD -YOU ARE
MAKING 5 COPIES GREEN, ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .............
Retaining Wall ...........
sia6insufation ..........
=i 5i
PLUMBING:
5i � ,
Underground ........... _
M
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0
Rough -in .................
-10
0 C
Commercial Final
M
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HEATING:,
C
GasTest ....................
>
Gas Piping .................
Equipment .................
n
-4
Commercial Final
M M
EXTERIOR SHEATHING
0
6 Fn
NAILING ... .............
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1,
1
K 0)
1
FRAMING ..................
rn 0
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
z
Wall Insulation ..........
Calling Insulation
SHEETROCK NAILING
0
IT!
SPECIAL INSPECTION
—7
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..............
2o02