20020642.pdfDATE RECEIVED 7;7) -1
PERMITEXPIRES 4a
us, P T
CITY OF EDMONDS ZONE NEURMIER '�,7_ - Olt)
-CONSTRUCTION PERMIT APPLICATION 'AZDRESS IUIIEIAITI
DINNER NAME/NAME OF BUSINESS
::4,�
74 PLAT NAMEISUBDIVISION NO, LOT NO, 11 N
L)
VA LING ADDRESS UD FEE S
2,7,1 PUBLIC RIGHT OF LVAY PER OFFICIAL STREET MAP
CITY EXISTING PROPOSED—
ITELEPHONE
- Z 4/Zd
Zip 20,�,, 76 7 _ Pa-1
REQUIRED
se
NO E3
In
NAME
-11+ �- -/- All T,�F
C L
S41 Z_ Z,
EN SERINO REVIEWED By ....
E N GfE 'IN IS V Im ED
GINS
ADDRESS
Upp T1 or 1, vent connectors
OD'y
Fill li4ffltdd on fuel-burningapplianc
d" 4
CITY ZIP TELEPHONE
55
Z 7 X,0 � i A � 96?0 5,16 JV2�- 77_�_.I, V,1
it
unheated svaces. UMC 815.1.7
U th cat e d s
M
z
a 8ORADBa NS2 1 BOND
S
STATE LICENSE NUMBER EXPIRATION DATE
6
rw),7,
!!!t�
H
R=ON
SOO
[3. [3N.
POSTED
S
,b,p/p/ '0 /_/ ,
III AREA
H"GH
PROPERTY TAX ACCOUNT PA.CE1 NO.
$EPA REV
COMPLETE E'XEMIT
ALLOWED , IROPC BED I
ALLOWED PROPOSED
EXP ,
NEW
RESIDENTIAL
'I"- AL
NG E.-
'..' 'M
)<1L...W.1MEC.
LOT D OVERAGE
ALLOWS C PROPOSED
I
REQUI ED SET ACKS (Fr.)
r R
FRO SIDE REAR
NT
PROPO ED SETBACKS (PILL
FRONT UR SIDE REAR
rn
C:
ADDITION
COMMERCIAL
OMM..CAL
MULTIFAIW
on
C MPLIANCEOR
'PLIANC.
USE
CHANGEOFUSE
N BE OF
sa
lin
0
PARKING LOT AREA PLANNING REVIEWED SY DATE
LOT
0
C
REMODEL
LY
MULTIFAMILY
SIGN
REO-10 I PROVIDES
REPAIR
GRACING CYDS
FENCE
X FT)
X
REMARKS
REMARKS
M IT!
z
I
10 I
017HER
DEMOLISH rl TANK
[3 RETAININGWALL C] FR SPRINKLER
g;
EiGARAGE
R An
CA POST ROCKERY FIRIE ALARM
(TYPE OF USE, BUSINESS OR ACTIVITY) a
TION
Cw 0
PA.�
cup
0 -n
0 a. ey
HICKID BY
ITYP. N
Typy
W9
MOW
GROB
t3
-n
NUMBER
OF
N MOER OF
DWELLING
CRITICAL
AREAS
SPEC L.INSPECTION JAR5A
100
LOAD
CUPANT
M In
STORIES
DESCRIBE WORK TO BE
U Hire
DONE
N MESA L,&l
Ec:�A
Is
0
REMARKS
PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION RECID
-9
0
c:
e4l
se
9
1171 0
5':R /7
Z r-
XAI �_&5e77
ALUAT'ON
V VALUATION
X
z
Vk-/ L/
Description
FEE
Description
FEE
Plan Check
FMechaniml
State Surcharge
0)
HEAT SOURCE
LOT SLOPE %
Building Permit
City Surcharge
PLAN CHECK
VESTED DATE
P I
Plumbing.
ITI
M c a icid
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THISPEFUarr COVERS WORK TO
HE DONEON PRIVATE PROPERTY ONLY. AMYCONSTRUCTION ONTHE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUESS. ETC.) WILL REQUIRE
2 SEPARATE PERM;SSION.
PE MITAPPLICATION: ISSIDAYS
Engr. Revi—
PERMITUMITIYEAR-PROVID D WORK IS STARTED WITHIN 180DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICANT. ON BEHAL OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire REVIEW
PlanChk.Deposft
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, IT' OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
OF THIS OF THIS PERMIT SHALL NOT
FROM THE ISSUANCE PERMIT. ISSUANCi
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINAN
Landscapeinsp.
Total Amt. Due
NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE N..
Recording Fee
Receipt It
Re a
C 'P'#
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMAL—
APPLICATION
APPROVAL
R VAL
GIVEN IS GO RECT, A 0 THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
R I
THE OWNER. I AGREE TO COUP WITH CITY AND STATE LAWS REGULATING CONSTRUC-
Ly
TION; AND K AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
CALL
's t�, n
T a�-d b
This application lano 101 11,mo by th.
Ncjntc�n Y' a 17d."and
B,iIdIAgOf1,,1,I,, Ne""' P.ty,: and Fees ins paid. and
I . d
IN VO_T Co.. OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Incelpt Is ack-1,dged In space p—Idint,
.a
WORKMEN! SURANCE AND RCW 18 27,
4F.ea
0 AT BE B 'S
DATE SIGNED
(425)
771-0220
7_ j
2
E EA B. ay
ATTENTION
Off 1333
IT IS UNLAWFUL TO USE 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. UBC SECTION 109
PINK -OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN - ACCOUNTING
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SET13ACKS .....................
FOUNDATION:
Footing .....................
Wall ...............
Pier/Porch ..................
Aetainln6
n
Slab Insulation ..........
0 rn
PLUMBING:
C:
R1 0
-110
Underground
0 C
*In
-4
Rougl�
ITI
ITIZ
Commercial Final
0-4
C z
HEATING:
Gas Test
pis
0 -n
n
Gas Piping ............
Equipment ...... ..........
MITI
Commercial Final
0
0 Fn
a co
EXTERIOR SHEATHING
9 (01)
M 0,
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...................
z
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
0
ITI
S HEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
t
OCCUPANCY ................
1&4 Al