20020737.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OW�ER NAMEINAMEPF BUSINESS.
.AILING ADDRESS
It G,i (; M E
CITY ZIP [TELEPHONE
CITY
0
PER T
12 f 55NUNIS0144z��—,,-�Z_;5'Z
JOB
ADDRESS
Z7'
t�awz
P�T NAMEISUBDIVISION NO.
LOT NO.
L N .
I
DFE$
L�D
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
In,
EXISTING — PROPOSED—
se-d--aPeo.
.a..
REQUIRED DEDICATION— FT
METER SIZE
LINE
PAN REQUIRED
I
YES E3 No E3 re
7EMARKS
OWNER/CONTRACTOR RESPO SIDLE FOR EROSION CONTR IUDRAINAGE
Spacm
11 — . � — I I I —
2 TELEPHONE
STATE LICENSE Nu. EXPIRATIJN DATE
��22N)v) NM23,
PROPERTY TAX ACCOUNT PARI
FIRE REVIEWED BY DATE
VARIANCE OR CU I S1101121101 OR ADBI I INIIIOTION 1, BOND
13YE!'s"103N. POSTED
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE I EXEMPT ALLOYdio PROPOSE. ALLOWED , PROPOSED
EXP
ri
A /
"G"`
IS (FT.) PROPOSED 6
LOT COVERAGE REQUIRED IETSAC ACKS (FT)
NEW
RESIDENTIAL
ALLOWED PROPOSED FRONT SIDE Ft.R FRONT U..ID. R..
ADDITION
-..FICIAL
C.ML N
G.GE0`FUS
REMODEL
MULTIFAMILY
SIGN
PARKING LOT NNING REVIEWED BY DATE
PROV IDED
0 REPAIR
GRADING CYOS
FE CE
( _ X_FT)
REMARKS
f-I DEMOLISH
rl TANK
13 -��G
n GARAGE
ITETAININGWALL
— FIRESPRINK I
CARPORT
0 ROCKERY
FIRE AI-AAM
(TYPE OF USE, SI�Mi; EX
CHECKED BY ITYPE 0 C.CUPA;�
OR UP
:3
NUMBER NUMBER OF
DWELLING
CRITICAL
AREAS
OCCUPANT
OF
'a
STORIES
I UNITS
NUMBER
LOAD
DESCRIBE WORK TO BE DON�
REMARKS
PROGRESS INSPECTIONS PER UBC 1108/1"INAL INSPECTION REO'D
5
$
W-rit If AWMM - /0
Description
FEE
Description
FEE
�14
-Ft I)H 6- o Irt t I ii
Plan Check
State Surcharge
P" GWI
(:F'WqU�;DLITI�M
Building Permit
City Surcharge
PLAN CHECK NO: I VESTED "IT'
Plumbing
THIS PERMIT AUTHOREVES ONLY THE WORK NOTED. THIS PERMIT COVER WORK TO
Mechanical
�fi2'
t: 8 GONE ON PRIVATE PROPERTY ONLY. AM CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALXS,DRIVEWAYS, MARQUE ES, ETCJ WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180DAYS
Engr. Review
& PERMIT UNIT I YEAR -PROVIDED WORK IS STARTED WITHIN ISODAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
IPPLICANT, ON BEHALF OF HI: OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO IND MNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
—
2 SOMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt N
IALL
FROM THE ISSUANCE OF 7 PERMIT. SSUANCE OF THIS ERMIT $HALL NOT HE
9 DEEMED TO MODIFY!, WAIVE OR REDUCE ANY REQUIREMENT OF NY CITY ORDINANCE
Landscapelnsp.
Total Amt. Due I
0 NOR LIMIT IN ANY WAY THE CITV'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
Receipt # 1�2
=By AC'NOW'ED 3ETH I HAVE READ THIS APPLICATION; THAT THE INFORMATION
Bly�='TEDGN'
"N
APPLICATION APPROVAL
C W 0
. T
R E �,ATHE�OYINIFL CTRATTEH E DULY AUTHORIZED AGENT 01
`V' 0 8 0 T ' TH TYAN6.
THE OWN I I AGREE To MPO` WITH CITY AND STATE LAWIS REGULATING CONSTRUC�
CALL
Thi..ppl 1-1-i—op—ilredii.iPmelicyth.
1 .0 . T ITEO OSK THOSIZED THEREBY. NO PERS N WILL BE EMPLOYED
- IN
A A D ' E STATE OF W,
V - F .0. OE OF THE STATE OF WASHINGTON RELATING TO
I I. T.. G THE Sol
B.,AX.R.Rd real or histher Carol, and Fees am paid, and
FOR INSPECTION ,jsc.ip1 hr,arko—lodg.d leap ... p—Ided.
k W UI2,
,WORKMEN B .. PENS ION I N RANGE AND RCYV 18,27,
(425)
MOF IIG�ATUFIE DATE
771-0220
�V
"P,5ASE. BY DATE
-ATTENTION' _U/
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
/A/7/
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
&SIGINZ F-11 E' - YEL OW JN9EC
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK,MNER - GOLD-ASSESSGRO
04102 PRESS HARD -YOU ARE
MAKING 5 COPIES GREEN - ACCOUNTING
z
0 M
MO
0
—10
0 C
M
M Z
C-4
z
co
0 "n
n
__4
M IT
re,
or —
OM
C IG
C En
In 0
z
z
-4
X
co
z
ITI
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ..........
FOUNDATION:
Footing......................
Wall..........................
PierlPorch ............
Z,
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
3:
Underground .............
0 M
C
ITI
0
Rough -in ...................
-4
0
Commercial Final
3: M
HEATING:
M z
g) -1
Gas Test .................
>
Gas Piping .............. kin
......... .
0 -n
Equipment .............
-n LU
Commercial Final
M IT!
EXTERIOR SHEATHING
a
0
NAILING ..........................
0
FRAMING ........................
M 0
FIRST FLOOR FRAMING
z
74
INSULATION ...................
Floor insulation
3:
>
z
Wall Insulation ...........
Ceiling Insulation
z
0
j
SHEETROCK NAILING
-4
0
SPECIAL INSPECTION
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................