20020714.pdfFA
DATE RECEIVED
CITY OF EDMONDS
OSE PE
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t2_ N MEIER
CONSTRUCTION PERMIT APPLICATION
JOB
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ADDRESS
WNER AMEINAM SINESS
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FLAT N,.E1g.RUvAE'oN NO, 70T NK;
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AILING ADDRESS
LID FEE III
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PUBLIC RIGHT OF STREET MAP
ITY ZIP ITELEPHONE
EXISTING — PROPOSED—
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REQUIRED DEDICATION— FT
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METER SIZE LINE SIZE NO. OF FIXTURES
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DORESS
OR RESPONSIBLE FOR EROSION CONTROL/DFAd4AOE
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FIRE REVIEWED BY DATE
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TATE LICENSE NUMBER
EXPIRATION
VAFILANCEOFCU
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11SPE.TIO
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POSTED
Ic BOND
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OYES ONO
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PROPERTY TAX ACCOUNT PARCEL NO
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
EIGHT
AL1.WE PROPOSED
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NEW
LOT C VERAGE
REQUIRED SETBACKS (Fr.)
PROP S D SETBACKS (Fr.)
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ALLOWED PROPOSED
FRONT SIDE REAR
FRONT LIRSIDE READ
A DDITION
COMMERCIAL
COMPLIANCE OR
CHANGEOFUSE
REMODEL
0 MULTIFAMILY
SIGN
PARKING I
HELD I PROVIDED
LOT A
77
NNING REVIEWED BY DATE
F1 REPAIR [3 GRADING CYOS FENCE
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REMARKS
0 DEMOLISH -TANK
OTHER
[3 GARAGE RETAININGWALL
CARPORT
ROCKERY
i UWE OF USE. BUSINESS ORACTWITY) EXPLAIN:
FFIRESPRINK dEA
REALARM
CHECKEDBY
JTYPEOF�
IC
NUMBER
NUMBER OF
CRITICAL
GCCUPAN),
ROUP 3
OF
DWELLING
AREAS
CTI N
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OCCUPANT
STORIES
U N TS
NUMBER
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REQUIRED [] YES
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LOAD
DESCRIBE WORWTO BE
DONE
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Description
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FEE Description FEE
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Plan Check
a n
State Surcharge
i HEAT SOURCE GLAZING % Or ILI", I
T SLOPE
R in
Building Permit
U id g Pt it
City Surcharge
TEO D ATE
�PLAN CHECK NO: VESTED DATE
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Plumbing
I In i,n g
ch am -a'
Mechanical
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THIS PERMIT AUTHORRIES ONLY THE W RK ..ED. THIS PERMIT COVERS WORK TO
""T COVERS WORK To
BE DONE ON PRIVATE PROPERTY ONLY. AUV CONSTR CTION ON THE PUBLIC
To Ing
Grading
:3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPAMTEPERM;SSION.
PERMIT APPLICATION: INDAYS
Engr. Review
PERMIT LIM T. I YUR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLIC ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
N U
IN INTEAWEST. AGREE$ TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE C2TY OF
aw
Fire Revi—
Plan Chill, Deposit
EDMOND', WASHIN T N, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS Fo DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt #
FRO' THE ISSUA LIE IF THIS PIRMI ISSUANCE 01 TIII1 PERMIT SHALL NOT BE
EEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT
Landscape InSp.
Total Amt. Due
OF MY CITY ORDINA CE
NOR LIMIT IN ANY WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
Receipt 0
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMAR N
APPLICATION APPROVAL
GIVE IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE DIVINE - I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
application Is,ot a portalt-11 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
FOR INSPECTION
InalThis
ding Official 01 his/her Deputy: I'd Fee, III Paid, and
doelpol!acke.whalgedileep .. P—ld.d.
WORI,EN'S INSURAICE AND HOW 1..27.
'd SO u-P
IMPENSATION
DATE SIGVED
(425)
ZtA./6y
1
771-0220
m�
H
ENTION
EXT 1333
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELLOW-INSPE
CATE OF OCCUPANCY HAS BEEN GRANTED. URIC SECTION 109
PINK -OWNER GOLD �AS%ESSORO
)4M2 PRESS HARD -YOU ARE
MAKING 5 COPIES GREEN - ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
s Aq-K&, ...................
�7B
Foodrii:
j
YWall ..........................
pier/Porch .................
z
4 Retaining Wall ...........
i
Slab Insulation ..........
PLUMBING:
Underground .............
-4
X l'
M
C:
Hough -in ..............
M
0
Commercial Final
0
HEATING:
ITI
M
a
Gas Test ....................
C
Gas Piping .................
Equipment .................
0)
0
Final
Commercial
3:
EXTERIOR SHEATHING
M M
0
NAILING ...................
0
0
FRAMING ................
C C,)
FIRST FLOOR FRAMING
M 0
INSULAT16N ...................
Floor Insulation
Wall Insulation ...........
z
Calling Insulation
SHEETROCK NAILING
z
SPECIAL INSPECTION
1TI
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................