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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PERMIT EXPIRES
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METER SIZE I LINE SIZE I NO. OF 11-UIES YSPIV 11OUIRED
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15
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE
4-161 7-
-171 RE FIEVIE.E. BY
DATE
STATE LICENSE NUMBER
EXPIRATION
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SIGN AREA
ALLOWED I PROPOSE.
HEIGHT
I ALLOWED PROPOSED
NEW 1:1 RESIDENTIAL PLUMBING t
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (FT)
FRONT SIDE REAR
PROPOSED SETBACKS (Fr)
FRONT LIRSIDE REAR
ADDITION
COMMERCIAL
COMILAGCCEOR
CHANGEOFUSE
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RED, PARKING I
B I PROVIDED
LOT AREA
PLANNING REVIEWED By DATE
MULTIFAMILY SIGN
n REPAIR
0 GRADING CYDS
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REMARKS
n DEMOLISH
rl TANK
El OTHER
ci GARAGE
CARPORT
RETAININGWALL
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(TYPE =OR Cm4fY) EXPLAIN:
CHECKED BY
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NUMBER
OF
NUMBER OF
DWELLING
ITICAL
AR AS
G"UMSER
SPECIAL INSPECTION
OCCUPANT
STORIES
GraTe
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OUIRE
LOAD
DESCRIBE WORK TO BE DONE
REMARKS as
PROGRESS INSPECTIONS PER USC 10B/FINAL INSPECTION REO'D
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Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE GLAZING 94
LOT SLOPE %,
Building Permit
City Surcharge
PIAN CHECM��/2_y I VESTED DATE
Plumbing
THIS PERMIT AUTHORIZES ONLY THE ORK NOTED, THIS PERMIT COVERS WORK TO
'WO
'Mechanical
t: .1
6 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2
Grading
:1 DOMAIN (CURDS. susEwALKrDRuvEwAvs MAROU -ES, ETC.) WILL REQUIRE
I: SEPARATEPERMiSSION. E
—
-E"V. Review
PE MITAPPUCATiON: la"DAYS
PERMIT LIMIT. I YEAR - PROVID 0 WORK IS STARTE0 WITHIN — BAY.
4W. In
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT, N BEHALF F HI OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Pavia.
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
—
a EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
IALL CLAIMS FOR DAMAGES OFWHATEVE NATURE. ARISING DMECTLYORMIDIRECTLY
Fire Inspection
Receipt #
FROM THE ISSUANG OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIE"W" E OR REDUCE REQUIREMENT
Landscapelnsp.
Total Amt. Due
Is's
ANY OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISIO'..
Recording Fee
___TREceIpt I
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I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT T14E INFORMATION
N
GIVE IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
Mp
THE OWNER. I AGREE To C. ITH CITY AND STATE LAWS REGULATING CONSTRUC-
'TH
CALL
This application Is not a p0arall until signed by Me
IN U MPLOY
TIO.; Alto .,NG THE W �KAU anIZED THEREBY, NO PERSON WILL BE EMPLOYED
0.
VIOLATI C. LA
IN 0 OR CODE THE STATE OF WASHINGTON RELATING TO
KC
WORKMEN's, TTR"NC AND RCW 18.27,
SiAlding Officittl a, heflar D-MAT -ad Fees M. paid, and
unce,
FOR INSPECTION pul—k—lodgedinspasup,celded.
SIGNED
OFFIC l' ALS DATE
,�IJATI
(425)
771-0220
MS1
7�1_
ABE' 8 ATE
ATTENTION
EXT 1333
I
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
j 'Yjli�,NSFECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
OR GINAL -FILE
ZK-OWNEn GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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1FINAL PROJECT -APPROVAL JkRM
TO:—
DATE:—
IsIEMOTO: PERmrr COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DAT13�1--2-?
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE_
PROJECT
TEINSP�ECTI
SITE ADDRESS -
PERMIT #
��AD DATEINSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine final compliance with approved plans. Final approval,
ere are no objections from the above signed Department to the release of
denotes that th
P 'ORMANCE BONDS and the granting of:
ERIF
S.--GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date— Sip—
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RECORD OF INSPECtIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ................
Wall ...............
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
4 -4
Underground .............
M
Rough4n ...................
I'D
0
Commercial Final
C
HEATING:
3: M
10
Gas Test ....................
a
Gas Piping .................
>
Equipment ..............
0 "Ill
-4
,Commercial Final
MM
EXTERIOR SHEATHING
vi
NAILING ..........................
0
0 Fn
FRAMING .................
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FIRST FLOOR FRAMING
INSULATION ...................
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FloorInsulation
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Wall Insulation ...........
Ceiling Insulation
(1)
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SHEETROCK NAILING
SPECIAL INSPECTION
0
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