20020702.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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USE PERMIT a(20_(DVa
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PLAT NAME]SUBDIVISION NO I LOT 110, D NO
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP hw P.,
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EXISTING — PROPOSED —
REQUIRED DEDICATION— FT UF=` .3
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROSID AINAGE
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ENGINEERING REVIEWS. By DATE
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FIRE REVIEWED BY DATE
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STATE LICENSE NUMBER U EXPIRATION
DATE 0 Y
Sit NCEORCU HORELME 08 ADO# it 'ON DONLE1.
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SEPA REVIEW SIGN AREA HEIGHT
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OMPLETE I EXEMPT, ALLOWE PROPOSED ALLOWED ER7
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RESIDENTIAL
1:1 PLUMBING I MECH
LOT COVERAGE REQUIRED SETBACKS (ED PROPOSED SETBACKS (FT�
ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR
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COIINP.LIANCEOR
.A E OF USE
PARKING LOT AREA PLANNING REVIEWED BY DATE
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NUMBER
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CRITICAL
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SPECIAL INSPECTION JANES OCCUPANT
LOAD
STORIES
UNITS
NuMBER
REQUIRED [3 YES
DESCRIBE WORK TO
BE DONE
REMARKS
PROGRESS INSPECTIONS PER USIC 1108ITINAL INSPECTION RF0`D
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Description
FEE
Description
FEE
Plan rChwk
State Surcharge
HEAT SOURCE G�ING % E LOT SLOPE
City Surcharge
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PLAN CHECK NO: ST11 DATE
Plumbing
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE W RK NOTED. THIS PERMIT COVERS WORK TO
C: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
2 DONAHN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
:3 MISSIOeL
t: SEPARATE PER
PE MITAPPLICATION: 1.VAYS
Engr. Review
PERMIT LNINT 1 YEAR - PROIN ED WORK IS STARTED WITHIN ' be DAYS
Engr, Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
—UCAM . ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCEEDED
IRMeview
Plan Chk, Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND SOLD HARMLESS TH, ,,,
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENI S FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt #
FROM THE ISSUANCE OF THIS PERMIT. ISSUANC� OF THIS PERMIT SHALL NOT B:
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Total And. Do.
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CSY ORDINAN
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OR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
rFire
Receipt # ILOLAW
I HEREBY ACKNOW EDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, on THE DULY AUTHORIZE AGENT OF
T E OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUG
H
CALL
This applies I,, is not a permit net signed by Me
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
B"I
FOR INSPECTION ho.IpH..okn.eI.dg.Bih.p p,.,Id.d
I WORKMEN'S (�OMPENSAT10jp"NCE AND RCW 18,27.
IG 11:LSIGNED
OR� E
8 NAT��
(425)
RELEASED BY
A17&N'rIONV
EXT 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-OWNES - 00 -ASSESSOR
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 ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final
HEATING:
Gas Test ............
Gas Piping
Equipment
Commercial Final
EXTERIOR SHEATHING
NAILING
FRAMING .................
FIRST FLOOR FRAMING_
INSULATION ............
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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