20020783.pdfCITY OF EDMONDS
CONSTRUCTION =PERMiT APPLICATION
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AREAS
I NUMBER
DESCRIBE WORK TO BE DONE
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PLAT NAMEISUBDIVISION NO.
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED—
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REQUIRED DEDICATION—
FT
METER SIZE
LINE Bile
No. 01 FIXTUR.
PRY REQUIRED
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No 13.
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
FIRE REVIEWED BY
DATE
VARIANCE OR CU
SHORELINE OR AD80
INSPECTION
BOND
POSTED
'EPA 11VIE
SIGN A. -A
EIGHT
COMILE I.
OWED
ALL I..10BED
ALLOWED PIOIOSEO
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MP
LOT COVERAGE
REG IRED SETBACKS (FT.)
PROPOSED 11TOAC%.(F
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AL ROPOSED
FRONT St E REAR
FRONT U. SGE
PARKING LOT AREA
IECIO I ��VIDIJ
I PLANNING REVIEWED By D;�
CHECKED BY I TYPE �ION 0 CUPANT
GROUP
1277
SPECIAL INSPECTION JAREA W Air
LIFED ,,,,,&CCUPANT,,,,
RED 1 13 YES LOAD
REMARKS
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$ 11
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Description
FEE Description FEE
Plan Check
State Surcharge
HEA G;374
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Building Permit
City Surcharge
TED DATE
Plumbing
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Mechanical
THIS FERMIT AUT-FIRIES .1NA` THREWORK NOTED. THIS PERMIT COVERS R K
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN ICURISS,SIDEWALKS, DRIVEWAYS, MARQUEES, STO't WILL REQUIRE
Grading
Grading
SEPARATE PERMISSION.
PE MITAPPLICATION: I.DAYS
Engr. Review
ng' Rev'
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK 01 PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HIEVIRS, ASSIGNS AND SUCCESORS
Fire Revievv
LE
Plan Chit. Deposit
IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON III OFFICIALS, EMPLOYEES, AND AGINTS 11111 ANY AND
Fire Inspection
Receipt #
IN
I ALL CLAIMS I.. DAMArEiB OF WHATEVER NATURE, ARISING DIRECTLY ORM DIRECTLY
FROM THE I GLANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY R.'NANc E
Landscape fnsp.
L S
Total Amt. Due �IZI D0 I
,
0
=1 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
_
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Recording Fee
Receipt #
I HEREBY ACKNOWLE GE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. IAGREETOCOMP WnH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
arwaPa"huntilsionedbyth.
TION. AND IN DOINgWOIII AUTHORIZED THEREBY. NO PERSON WILL 81 EMPLOYED
V'CLAn.N OF .. ODE OF THE STATE OF WASHINGTON ABLATING TO
WORKMEZ COMPE A AND RCW 11,11,
FOR INSPECTION
ste,ThIsappi-to
aft XrWran Barney: and Fee, are paid, at ai
?INSURANCE
NI SIGNED
(425)
0 ICIALS `UGNATU;� DATE
�
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1 10 4A17JA
771-0220
RELEAKL D IS
A77ENTION
M 1333
07
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 YELLM-INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK-MNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE A PPROVED
SETBACKS .....................
FOUNDATION:
f-AdJ,
Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wall ...........
Stab 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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