20020823.pdfDATE RECEIVED
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PERMIT EXPI�RES��
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CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
JOB SIATEIAPT
ADDRESS tk,44i W oT— Sr. 4� L-
OWNER NAMEINAME OF BUSINESS
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FLAT NAMEISUSDIVISTON NO� 7.
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LID FEE S
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CITY
EXISTING— PAOP.ES.—
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NAME
LINE SIZE No. OF FIXTURES PRV REQUIRED
METER SIZE ar
YES C3 NO
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ADDRESS
CITY ZIP ITELEPTIONE
REMARKS
NERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
NAME
JISLI
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ENGINEERING REVIEWED By DATE
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ADDRESS
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VARIANCE 08 CU INSPECTION SON
STATE LICENSE NUMSEB EXPIRATION -K.. Y REDD POSTED
OyEs ONG S
-7 -7 SERA REVIEW SIGN AREA EIGHT
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
DOM
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EXP I
EXP —
IRIFAIFRI,
LOT COVERAGE REQUIRED SMACKS (Ill PROPOSED SETBAC I
NEW RESIDENTIAL rl PLUMBINGIMECH AtLOWEO PROPOSED FRONT SIDE HEAR FRONT UR SIDE
C MPLIANCE OR
ADDITION COMMERCIAL CHANGE OF USE
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PARKING LOT AREA ��� DATE
rl REMODEL K MILLAIMLY 0 SIGN REDD I F.IWI.E.
AC&
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GARAGE ING SPRINKLER
[3 ACETCAK'NERY WALL El FIREALARM
CARPORT
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(TYPE OF US�, BUSINESS OR ACTIVITY], EXPLAIN: STRUCI CU T
CO] 0 "7
1HECK11 BY UPA
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NUMBER NUMBER .1 RT.AL
UPA T
OF 'WEI I ING SP CIALINIPICTION OCCU NT
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LOAD
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2�� _S INSPECTION REDD
PROGRESS INSPECTIONS UBC INS P.CT.O
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VALUATION
$ 14,41S6—
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Description
FEE
Description
FEE
Plan Check
State Surcharge
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BEAT SOURCE PE%
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City Surcharge
PLAN CHECK NO:
Plumbing
Mechanical
THIS PERMIT AUT ORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
I ES. M )WILLREQUIRE
3 DOMAIN (CURBS, SiDEWALKS.DRIVEWAVS, MARQUE
SEPARATE PERMISSION.
—
Engr. Review
PERMITAPPLICATION: ISO DAYS
PERMIT LUMM I YEAR -PROVIDED WORK IS STARTED WITHIN 100DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
�APPLJCANT 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 OF
Receipt #
2 EDMONDS, WASHINGFON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM, ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING D AA"T A Y
Fire Inspection
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT 'E
LandEcapainsp.
Total And, Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
o NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE A14Y ORDINANCE PROVISION..
14m5o
Record Ing Fee
Receipt #
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE Nn I—
APPLICATION APPROVAL
rVEN 15 CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHOR ZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE Laws REGULATING CONSTRUC�
CALL
Thl-ppfic.O.o I.ran. Pal.4-il aio add by Or.
TION; AND IN DOINGTH WORK AUTHORIZED THEREBY, NO PERSON WILL 05 EMPLOYED
Building Offilill or ladhor0opIty: and Fee arlpaid,and
Ia.cI,n-1.dg.d in.p..
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'E�_�SATION NN UFUNCE AND RCW 18,27,
FOR INSPECTION p—ld.d.
OF
SIGNALE OWL11E11 Y91 A a DATE S IGNED
(425)
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771-0220
fDAT8f
ATTENYION
M 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI.
OTUGINAL- FILE YELLOW INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
PINK OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ..................
FOUNDATION:
Footing .............
wall
Pier/Porch
Retaining Wall
Slab Insulation
PLUMBING:
Underground ............
M
Rough -In ...................
ITI
0
0
Commercial Final
C:
HEATING:
x M
M z
Gas Test ............
Gas Piping ...............
Ecluipment ..........
In
Commercial Final
IT! M
EXTERIOR SHEATHING
On
0—)
NAILING ...........
0
0
C=
FRAMING .....................
ca
Q 0
FIRST FLOOR FRAMING
—dd�-
INSULATION
;D
...................
Floor Insulation
z
Wall Insulation ...........
Ceiling Insulation
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0
SHEETROCK NAILING
SPECIAL INSPECTION
0
ITI
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................