20020680.pdfDATE RECEIVED
JUL [PERM EXPIRES(_1f__1=
U' E ERMIT
CITY OF EDMONDS ZONE P
NUMBER
CONSTRUCTION PERMIT APPLICATION JOB CSS
ADDS
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LINE SIZE I NO. 01 FIXTUAIS
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A....A REMARKS
or OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY
NAME ICBLy I
CITY
STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY
PROPERTY TAX ACCOUNT PJtRCEL NO.
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FIRE REVIEWED BY DATE
VARIANCE OR CU IMORELNIOA'De' INSPECTION ION
POSTED
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0 [3 S
SEPA REVIEW SIGN AREA HEIGHT
OWED PRO
COMPLETE EXEMPT ALL POSED ALLOWED , PROP D
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LOT COVERAGE REQUIRED SETBACKS FT.)) 0 OS D SETBACKS (FT.)
0 NEW )CRE&DENTAL [0:] LUMBINGIMECH
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ADDITION COMMERCIAL C
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REPAIR 0 GRADING Cyca PENCE
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GARAGE RETAININGWALL o F ARE SPRINKLER
CARPORT ROCKERY F! 11A,
(TYPE OF USE, BUSINESS OR ACTIVITY)
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NUM.0,E" Ea OF CRITICAL
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SPECIAL INSPECTION
OCCUPANT
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REQUIRED [:] YES
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
EROGRESS INSPECTIONS PER USC 1081FINAL INSPECTION REO'D
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Description
FEE Description FEE
Plan Check
"7
State Surcharge
Z/50
HEAT % LOT SLOPE I
to JqRCE 1 A3rG
Building Permit
City Surcharge
PLAN CHECK NO: nFE. DATE
0!
Plumbing
THIS PERMIT AUTHOR ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
t: 8 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (cunas, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMDTAPPUCATIONI 150DAYS
PERMIT LIMIT. I VUR _ PROd 90 WORK IS STARTED WITHIN ISODAYS
SSE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
*APPLICANT. ON BEHALF 01 HIS OR HER SPOUSE. HEMS, AISIGNI AND EUCCEI.FS
Fire Review
PlanChk.Deposft
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AN AGENTS FROM ANY AND
Fire Inspection
Receipt # 0
AULCLAJMSF0 DAMAGES OFWHATEVER NATURE, ARISING ENRECTIYORINDIRECILY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE F THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINAN E
Landscapeinsp.
ITctalArnt...JJCV�50
0 NOR LIMIT IN ANY WAY THE CHYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
Receipt #
1 HERESY ACKNOWLE BE 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 AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This appt aeflon Is not a permit hatil skated by bar
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOILAT�ON. HIaLAINOR CODE OF THE STATE 01 WASHINGTON RELATING 1.
FOR INSPECTION
Sua date Opfic�af or Nalhor Deputy: ad Fees am paid, and
retailer is imha-Wrigodur Imea vould.d.
WOAKM. EE T. INSURANCE AND Now 18.27.
SIGNATUR�, Alie"16,
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(425)
'OFF )A�S
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SAT
ATTENTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL-FtLE YEULOW�INSPECIOA
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK - OWNER G LD - ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNT114G
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ........... nas o. f
FOUNDATION:
Footing ......................
Wall ..........................
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Pier/Porch .................
Retaining Wall ...........
Slabinsulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
Gas Test ..........
Gas Piping .................
Equipment ...........
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
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FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ................
The initials RSR are Rick S.
Roberts, a temporary contract
inspector for the City.
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