20020788.pdfATE RECEIVED
PERMIT EXPIRES
CITY OF EDMONi�S
USE PER 'IT
ZONE
NUMBE.,
CONSTRUCTION PERMIT APPLICATION
JOB S ITFIAPT#
OWNER NAMFINAME OF BUSINESS
ADDRESS S*�"c
<,
D',�',—AAD I
PLAT NAMEISUBDIVISION NO.
LOT —No,
, I
L�D MO.
_
M AILING ADDRESS
L D FEE S
PUBLIC 81014T OF WAY PER OFFICIAL STREET MAP
TESOP M,Pn! 0
A.
Iva,
CITY ZIP TELEPHONE
EXISTING — PROPOSED—
=LN-a-a 13
13
NAME
MET
a e
Lws vqntiacannedws
PAV RE4
RED
M1
requI
edonfueI1UrningaPPIi*eC8qh
ING
E3
ADDRESS
R M
0
I R 0 RAP(PN599 FYFM&C MINAGE
CITY ZIP ITELE111
ME
NAME
ENGINEERING REVIEWED BY DATE
ADDRESS
-z_
CITY ZIP I
<
TELEPHONE
RE REVikgD By
open or of,,
1'.. Ou, tinks are
z
rNI;I -11 1 � . .
0
STATE LICENSE NUMBER
EXPIRATION
VARIAM.P
vlt�
111k _QR
CO
.
I&PIE
0
W11 Co)
clato
prNDB
STE
PROPERTY TAX ACCO MY
COMPLETE EXEMPT
V SIGN AREA -
ALLOWED PROPOSED ALLOWED
_T"GHT
PRO, OSED
63 (6)
9 7 t) I rW3 1)
,
EXP
NEW
SIDENTIAL
UMBING/MECH
LOT COVERAGE
REQUIRED SETBACKS (FT) PROPOSED
SETBACKS (Fr.)
m
ALLOWED PROPOSED
FRONT SIDE HEAR FRONT
URSIDE BEAR
on a
ADDITION
COMMERCIAL
C MPLIANCE OR
CHANGEOFUSE
z
0
C
rl REMODEL
MULTIFAMILY
13 SIGN
PA
REDD ROVIDE
LOT I
DATE
A.
___f _._.,NG
11
X M
[3 REPAIR C..
rl FENCE
Obtif.
R___
I
I
IT
X—FT)
REMARKS
Z,nhar
10
E3 DEMOLISH TANK OTHER
I'lifilletr;0i;
C 2
>
GARAGE FIETAININGWALL FI EEPRINKLER
.__ —_
CARPORT 1Y FIRE AILARM
ROCKE [j
ITYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
q -n
CHECKED BY ITYP
Yp
BE
NUMBER
OF
NUMBER OF
DWELL NG
AREAS
CRITICAL �Vjl�
JOCOU
UPANT
:C 111
on
SPECIAL INSPECTION
OCCUPANT
STORIES
UNITS
NUMBER
REQUIRED n YES
JAFIEA
LOAD
0
0
III
REMARKS
0
PROGRESS INSPECTIONS PER UBC 108/FiNAL INSPECTION REQ'D
C:
9 cl)
z--
ITI 0
A_
Z
Z11 40d( 1/2
VALUATION
Al
$
z
escription
FEE
Description
FEE
Plan Check
State Surcharge
z
HEAT SOURCE 13LAIING I LOT $LOPE % 1
Building Permit
City Surcharge
5
0
:j
PLAN CHECK NO: VESTED 6ATE
Plumbing
0
orl
_===
THIS PERMIT AUTMORRES
Mechanical
ONLY THE WORK NOTEM THIS PERMIT COVERS WORK TO
ONE BY IFIRVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLI
DOMAIN SIDEWALKS,
Grading
(CURDS, DRIVEWAYS, MARQUEES, ISTC.) WILL REQUIRCE
SEPARATEPERMISSION.
. ..... ....
PL
Engr. Review
MITAPPLICAMON INDAYS
PERMIT Uum I YEAR - PROVIDED WORK IS STARTED WITHIN .a DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
'APPLIC W. ON BEHALF OF HIS OR HER SPOUS � HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIAII� EMPLOYEES. AND AGENTS I'D,, ANY AN"
Fire Inspection
Receipt #
!31
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF IRS PERMIT SHALL NOT BE
DEEMED TO MODIFV, WAIVE OR REDUCE ANY REQUIREMENT OF ANY C ORDINANC
Landscapeinsp.
Total
Amt. Due
0.
NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANICTEY PROVISION'
Recording Fee
Receipt
#
a�l
I HERESY ACKNOWLEDGE THAI I RAVE READ THIS APPLICADON; THAT THE INFORMATION
GIVEN IS CORRECT�, AND THAT I AM THE OWNER, on THE DULY AUTHORIZED AGENT OF
APPLICATION
APPROVAL
OM
Cc
THE OWNS IAG11E MPIN WITH CITY AND STATE LAWS REGULATING CONSTRUC
'I'M
CALL
Ths application Isnota pancittanil Mao.d b,
TION; AND GOING T WORK AUTHVIZED THEREBY. NO PERSON WILL BE EMPWYEO
B"ll"Ing flicl.l.rhla D.p.Y:.rdFanc.n.p.Id,aPd
N ON C, I
E$BOR CODE F THE STATE OF WASHINGTON RELATING TO
N
N �AN E AND How 18.27.
FOR INSPECTION
I
0- Do Is acko/Zeditol In.paca prmided,
DATE 31.11E.
(425)
OFFI LINE DATE
�j 'i7t)-
�Nn
(� �= I
It , . _6,o
, ...
ATTERTION
EXT 1333
RELEASED BY DATE
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. USC SECTION 109
OR GINAL FILE - YELLON, INSPECTOR
04102
P�N�-OWNER - GOLD-ASSESSOT
PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
RECORD 0 F INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ..........
FOUNDATIOW
Footing ......................
Wall ..........
Pier/Porch . ................
Retaining Wall ...........
0
Slab Insulation
PLUMBING:
Underground ...........
3:
M
Rough -in ................
ma
Commercial Final
HEATING:
X M
ITI z
Gas Test ............
Gas Piping ...............
Equipment ..........
Commercial Final
M M
EXTERIOR SHEATHING
0 F)
NAILING .................
0
0
FRAMING ...........
C
9
M 0
FIRST FLOOR FRAMING
INSULAT16N ..........
Floor Insulation
z
Wall Insulation
-q
Ceiling Insulation
z
SHEETROCK NAILING
SPECIAL INSPECTION
0
IT
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................