20020779.pdfa-- FPER;7iT ExPIRES
USE PERMIT
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CON' STRUCTION PERMIT APPLICATION JOB UITEIAPT#
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ITY zip IILEP40111 VARIANCE OR CU IHORELIIE OR AD"
STATE LICENSE NUMBER 'Ti � ON �..ED BY I
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LOT COVERAGE REQUIRED S
ALLOWED PROPOSED FRONT SI
ACKS (FT) PROPOSED SETBACKS (FT.)
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ADDITION
El COMMERCIAL o COMPLIANCE OR
CHANGE OF USE
FIXING LOT AREA PLANNING REVIEWED By
REMODEL
APARTMENT SIG14
REGO PROVIDED
F] REPAIR
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[3 GRADING CYDS X Fit
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TANK 0 OTHER
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RETAINING WALL
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WORK TO BE DONE
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PROGRESS INSPECTIONS PER UBC 10S/FINAL INSPECT ION REO'D
VALUATION $
Description
FEE
Descripti
---I
FEE
Plan Check
HEAT SOURCE OWING % LOT SLOPE %
PLAN CHECK N VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORCIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Be GONE ON PRIVATE PROPERTY ONIM ANY CONSTRUCTION ON THE PUBLIC
Grading
Recording Fee
3 DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,) WILL REQUIRE
SEPARATE PERMISSION.
Engr, Review
City Surcharge
PE "APPLICATION. IN DAYS
PERMIT LIUM, I YEAR PROVID D WORK IS STARTED WITHIN IN DAYS
State Surcharge
�a BACK OF PINK PERMIT FOR MORE INFORMATION
BE
'APPLICANT, ON BEHAt OF HIS ON HER SPOUSE. HEIRS�ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan C it Deposit 71-0
IN INTEREST. AGREES TO 11 DEMNIFY. DEFEND AND HO D SARIS EBB THE CITY OF
Receipt
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DISECTIY OR INDIRECTLY
BE
Fire Review
Due i
FROM THE I SUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT
a CE
DEEMED TO MODIFY, WArVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORIANAN
Fire Inspection
Total Amount
I —22—
NOR LIMIT IN ANY WAY YHE CITTS ABILITY TO ENFORCE ANY
Landscape nap.
Receipt # _111LU
I HEREBY ACKNOWLEDGE THAT HAVE'READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT AM T 05 OWNER. OR THE DULY AUTHORIZE AGENt OF
�
rhis appliei III- nn,n pr,.J,vnnINgr.d by ffi.
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
BE EMPLOYED
CALL
S"t umg I., In, DI,PIAY: d F pInd, rd
TION; AND IN DOING THE WO K AUTHORIZED THEREBY, NO PERSON WILL
TH R
IN VIOLATION OF E LABOR CODE OF THE STATE Of WASHINGTON RELATING TO
c�
FOR INSPECTION 012WInd In �p .. pn.,.d.d.
WORKMENS COMPENSATION INSURANCVND HOW 18,27.
OFFICI LS N UR�F DATE I
SIGNATURE (OWNER DATE SIGN
(425)
::,�A�O
771-0220 Y DAfE
ASED
ATTENTION_��---7'
EXT 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
OFSPGIINAL FdE YELLOW - INSP T R
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ...........
FOUNDATION:
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Footing .................
wall
Pier/Porch ...............
-4
0
Retaining Wall ...........
M
Stab Insulation ..........
PLUMBING:
co
3:
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Underground ...........
M
0
Rough -In ..............
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Commercial Final
A
M
HEATING:
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to -q
Gas Test ...........
Gas Piping
11"';
Equipment
-4
3:9
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Commercial Final
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EXTERIOR SHEATHING
0
NAILING ................
FRAMING ........................
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FIRST FLOOR FRAMING....
INSULATION .............
Floor Insulation
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Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
0
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SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY .................
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