20020781.pdfT OF EDMONDS
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PERMIT EXPIRES
USE (/ PERMIT /
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ADDRESS 10 17110
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PLAT NAME/SUBDIVISION NO. LUT No ` 1 LID N0.
LID FEE $ ppp
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Ty/. -I a-uaad p
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EXISTING PROPOSED —sloe erlh Peo Ired p
REQUIRED DEDICATION FT WINra oquruoa D
METER SIZE I LINE SIZE 1 NO. OF FIXTURES PRV REQUIRED a7
YES ❑ NO Q x
REMARKS x
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONT0.000MINAGE
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STATE LICENSE NUMBER EXPIRATION DATE ED BY VARIANCE OR CU SHORELINE OR ADB,I INSPECTION BOND
POSTED
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SEPA REVIEW SIGN AREA HEIGHT
POPE TYT •P RCF,L 9jQ. \a Y O COMPLETE EXEMPT ALLOWED PROPOSE LOWED PROPOSED
EXP ��
NEW RESIDENTIAL PIUMBINGl MECH LOT COVERAGE REQUIRED SETBACKS (FT.) ROPOSED SETBACKS (FT.)
❑ ❑ ❑ ALLOWED PROPOSED FRONT SIDE REAR FONT UR SIDE REAR
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COMPLIANCE
ADDITION COMMEACIAI OR
❑ ❑ � �^
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CHANGE OF USE—�
LOT AREA PLANNING REVIEWED BY DATE
❑ REMODEL ❑ MULTIFAMILY SIGN BE 0'D ARKPROVIDEDOU
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❑REPAIR GRADING
❑ CYDS ❑ ( %FT) REMARKS
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❑ DEMOLISH ❑ TANK ❑ OTHER
❑GARAGE WALL ❑
INtINGFIRESPRINKLER
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RPORT DOCAKERY FIREAIARM
(TYPE OF USE, BUSINESS OR ACTH fn1 EXPLAIN:
(,� (•--I� ,A„ tz__'r CHECKED DY TYPE 0 N OCCUPANT
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GROUP
NUMBER NUMBER OF CRITICAL
OF OWELIfNG AREAS SPECIALINSPECTION AREA OCCUPA
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STORIES UNITS NUMBER REQUIRED ❑ YES LOAD
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 10811FINAL INSPECTION REO'D
G?A. e- t ICJ IF—T. VALUATION
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FEE
Description
FEE
StateSurcharge
HEAT SOURCE GLAZING % LOT SLOPE %ermi[
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CHECK NO: vesTep DATE
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_ THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
Grading
� DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
9
SEPARATE PERMISSION.
Engr. Review
PERMITAPPLICATIRK:
STARTED /80 DAYS
PERMIT LIMmiCK
Engr. Inspection
OFPERMIT FOR M REINFOWITHIN
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk, Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OFl
t EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
'iS
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
9 FROM THE ISSUANCE THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY,
Landscape Insp.
Total Amt. Due
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WAIVE I REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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x NOR LIMIT IN ANY WAY THE CITYS ABILITY 10 ENFORCE ANY ORDINANCE PROVISION.'
-
Recording Fee
Receipt #
- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
•
ICATION 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.
CAL`
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TON; AND IN DOING THE WORK AUTHOFlIZED THEREBY, NO PERSON WILL OE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
F THE E OF
FOR INSPECTIONne
or I lhor Dopuly: antl Nos Aro paid, a
awlotlyod lnepo provltl
WORKMEN'S CO CE AND RCA
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(YGJ)I771-0220
ATTENTION
EXT 1333IT
IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
08 GINAL•FILE • YELLOW - INSPECTOR
PINK -OWNER • GOLD -ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
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Wall
Pier/Porch .................
.`.Retaining Wall::.:.....:. _.
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Slab Insulation ..........
PLUMBING:
Underground ........... -
-
Rough -In ..........
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Commercial Final ......
HEATING:
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Gas Test ....................
iGas
Piping .............
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Equipment ....:........
Commercial Final :......
- EXTERIOR SHEATHING
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NAILING -. ••
FRAMING ........................
..
FIRST FLOOR FRAMING... ,.
INSULATION ...................
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Floor insulation .........
Wail Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
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" SPECIAL INSPECTION ...