20020786.pdfe
� —DAT� RECEIVED
PERMIT EXPIRES
I L 4444
CITY OF EDMONDS
C PERMIT
UONE 9512- NUMBER YL
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CONSTRUCTION PERMIT APPLICATION
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ADDRESS
OWNER BUSINESS
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FLAT NAMEISUBDIVISION NO. LOT NO,
LID NO,
MAILING A DRESS
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
CITY
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YES 13 NO C3
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2 WINFRICONIRACTOR RESPONSIBLE FOR EROSION CO.TROLIORAINAG
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CITY ZIP
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NAME
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FIRE R ItIVEOpen or Closed. eypaos,ion toliksoAare
CITY TELEPHONE
jraquimd on all hot Vimr tarks
per
STATE LICENSE NUMBER EXPIRATION
VARlANjdIjflPLk;o(Ir,StW1W d"P.94 3OND
E I DSTED
"��GATI
I- PCs -A I, C�i qo 'j I
7A—
PROPERTY TAX ACCOUNT RCEL NO.
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED IIIOPOIED ALLOWED PROPOSED
or
EXP , ,
rl NEW ET�EEIDE.TIAL tf-PLI.I.E114GINIEC.
LOT C VERAGE REQUIRED SEGIACKS (FT.) PROPOSED SETBACKst (Fr.
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR)
[3 ADDITION F C MPLIANCE OR
COMMERCIAL CHANGEOFUSE
REMODEL MULTIFAMILY f-1 SIGN
P I —hy
BE-. F"dtilStriles
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rl REPAIR GRADING
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rl DEMOLISH TANK OTHER
0 GARAGE RETAININGINALL F HE SPRINKLES
L-1 CARPORT AOCKE�Ry FIRE ALARM
(FYPE OF USE, BUSINESS OR ACTIV" EXPLAIN:
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OCCUPA
GROUP
k.P.ILINSPEj.�.�AREA
NUMB NUMBER OF CRITICAL
OF DWELLING AREAS
I I I
OCCU NT
STORIES f 7A I-' UNITS NUMBER
DESCRIBE WORK TO BE DONE
LOAD
REQUIRED [] YES
REMARKS
PROGRESS INSPECTIONS PER UBC 10$/FINAL INSPECTION REOD
V
N ALUATIOti
7
Wo Ntim Pjj2iL�e
Description FEE Description FEE
I 1 0
Plan Check
StafteSuicharge
GLAZING % LOT SLOPE %
Building Permit City Surcharge
PLAN CHECK NO:
Plumbing
Mechanical
THIS PERMIT AUTHORIZES 014LY THE ORKNOTED, THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THEPUBUC
X
Grading
:3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
S PARATE PERMISSION.
Pe MITAPPLICATION: INDAYS
Engr. Review
PERMIT LIMIT. I YEAR-PROVID 0 WORK IS STARTED WITHIN 180DAYS
Eng, Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
—PLI . ON BEHALF OF 1111 OR "Ea SPOUSE, H1111. �SIIGNI AN. SUCxES..g
Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARM ESS THE CITY OF
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection Receipt #
ALL CLAIMS FOR OAMAGES OF WHATEVER, NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT SSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF NY CITY ORDINANCE
Landscapeinsp. Total Arm Due
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
I HERE ACKNOW111CI THAT I HAVE READ Due APPLICATION; THAT THE INFO MATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
This appi call,n is not a pennut until signed by ths,
CALL
TIOW AND IN DOING THE WORK AUTH IZED THERE No PENS N WILL BE EMPLOYED
a 6 F THE ETWATE F WASHINGTON RELATING TO
I. VIOLATION OF T H S NfE
aug dlhg OffI2.1.1hieflun, Deputy:.hd rent,.n. p.1d,..d
FOR INSPECTION n.sslpHs.ckn—l.dg.dI..p ... ph.kl.d.
T �E
SU D C 7
WORKMEN'S tOMPE SAW AN R 10[to
SIGNATURE (rER OR A -NT)
OFFIJ SIGBATURE
(425)
D
771-0220 RELEAIED BY
ATTENMON
EXT 1333
IT 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
ORGINAL-FILE - YELLOW. INSPECTOR
PINK -OWNER - GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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REC09D OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
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Pier/Porch
Retaining Wall
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Slab Insulation
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PLUMBING:
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Underground
M
.............
Mv,
0
Rough -in .............
0
Commercial Final
C
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HEATING:
—4
C Z
Gas Test .............
>
Gas Piping .............
0'r
Equipment . ................
'n
Commercial Final
III! M
EXTERIOR SHEATHING
0
0
NAILING ..........................
C
co
FRAMING ........... ............
0
FIRST FLOOR FRAMING
INSULATION .............
—4
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
0
IT
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
79