20020671.pdfE 1
DATE REC;IVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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0 NEW
RESIDENTIAL
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ADDITION
COMMERCIAL
COMPLIANCE OR
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ADDRESS 13( �.4 "Ju e I., 7C
FLAT NAME/SUDDIVISION NO. I LOT NO. L
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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EXISTING 6� PROPOSED
REQUIRED DEDICATION tl� FT _14:�_
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METER SIZE I LINE SITE 110, or 1IXTUR. PFIV E.UIR
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OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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60&-y6i 200 nldg Description FEE Description FEE
Plan Check State Surcharge CI)
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City Surcharge
VESTED DATE Plum Ing 0
PLAN CHECK NO M
'i, ;3 Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSIR CTION ON THE PUBLIC
Grading
OMAIN (CURBS,
D SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Revievv
PE MITAPPUCANIO.: ISO.
PERMIT UrNar� I YIUMi - PROVIDED WORK 15 STARTED WITHIN ISO DAYS
Engr, Inspection
SEE BACK Of PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON BE-11 OF HIS On HER SPOUSE, HIIIS. AIIIGII AND IUCCESURS
Fire Ravi"
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
I ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt #
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY WA VE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapainsp.
Total Amt. Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
Recording Fee
Receipt #
I HERE 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 AP ROVAL
THE DIANE . I AGREE TO COMPLY WITH CITY AND STAT LAWS REGULATING CONSTRUC
CALL
M.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING To
WORKMENS N INSURANCE AND RCW 18.27.
NSATI
FOR INSPECTION
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OFF SIGNATURE
ATU 0 AG N
DATE
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JIGN
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771-0220
RE V DArE
ATT#NTION
Off 1 '333
IT IS UNLAWFUL TO U6E I I-G OWSTRUCTURE UNTIL
P
-CUP
VE iNID
A FINAL INSPECTION HATIBEEN M APPROVAL OR A CERTIFI�
OR'GINAL.F'LE YELtLTINSPE
ATE OF OCCUPANCY HAS BEEN GRANTED. LED SECTION 109
P;NK-OWNER GOLO�ASSESSOH
12 PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN - ACCOUNTING
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing .............
wall
Pier/Porch .................
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Retaining Wall ...........
Slab Insulation ..........
M
PLUMBING:
Underground
.. ...........
M
M
Rough -In ...................
0
C=
Commercial Final
H"TING:
M
Gas Test .................
Gas Piping .................
Equipment
0 "Irl
Commercial Final
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EXTERIOR SHEATHING
W
0
NAILING ................
0
FRAMING ........................
FIRST FLOOR FRAMING..,
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INSULATION ...................
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Floor Insulation
Wall Insulation
Ceiling Insulation
CA
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SHEETROCK NAILING
SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ...........
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