20020838.pdfCONSTRUCTION PERMIT APPLICATION
OWNER NXME/NXME OF BUSINESS
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MAILING ADDRESS
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CITY ELEPHoNE NUMBER
NAME
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PERIT
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S ITE/APT
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SUBDIVISION NO
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LIU No
PUBLIC RIGHT OF WAY PER OFFIC14L STREET MAP
TESCA Approved 0
EXISTING —
REOUIPE. BE.ICATI.H —
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$1
GEED
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METERStZE
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REMARKS
I
LLNE AS IT ENFERST1116 BUILvils"
ENGINEERING MEMO DATED EvImED BY
FIRE MEMO DATED PURSUANT TO ECDC 19.30.02�0E""EDS'
WA6%W&" .8
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VARIANCE OR CLSIIALL
BE M"IALLEE
NEWEEINE.
Legal Description of Property -M.Az4m.i
SERA REVIEW
COMPLETE I EXEMPT
EXP
W1WAM-=1
U I
HEIGHT
LOTCOVERAGE
ALLOWED I PROPOSED
REQUIRED SETBACKS JF`L)
F ONT 8105 PEAR
PROPOSED SETBACKS (FT.)
FRONT UPSIDE REAR
".P.,ty
Pame. N..
T"A'c"iG (Do5-/31o0Q03-�0V
LOT AREA
PLANNING REVIEW BY
DATE
H. RESIDENTIAL PLUMSINGIWECH
C MPLIANCE OR
ADDITION COMMERCIAL CHANGE OF USE
REMODEL APT. BLDG. SIGN
GRAOINO Y.E FENCE
REPAIR X—FT)
aWrM Poo
DEMOLISH oODSTOVE F HOTTUS.L, A
INSERT
GARAGE RETAINING WALL/ RENEWAL
CARPORT ROCKERY
. REMARKS
1HECKED BY T 0, cc T YOTION
CODE
OCC-P T
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SPECIAL INSPECTOR
REOUIRED a YES
AREA
... UPA.T
IIA17
REMARKS
PROGRESS INSPECTIONS PER LISC 108
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0 (TYPE OF USE B SNIESS OR ACTIVITY) EXPLAIN:
S'i ('4 - C P-
NUMBER
OF
Pre Is IES 2-
TOR
OF
DWELLING
LINITS
JA M
PEAS
NUMBE R MA
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN�
I�of cofIL ter
FINAL INSPECTION REOUIRED
FEE
LUM bAbl --m CiTygn"
VALUATION
I
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
OLAZI�G
Be
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY,
GRADINGIFILL
Any construction on the public domain (curt�s, sidewolks,
riveways, marquees, etc.) will require separate permission
—
S.*M-SURCHATIGE
Pem:t Application: 180 Days
Perm I Limit: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
Su"Applicarij, on behalf of his or her spouse, heirs, assigns and
ccessors IT interest, agrees to Indemnify, defend and hold
harmless the City of Edmonds, Washington. Its officials,
z� employees, and agents from any and all claims for damages of
IF
< Whatever nature. arising direct ly or Indirectly from the Issuance
. of this permit. issuance of this permit shall not be deemed to
9 modify. waive or reduce any requirement of any city ordinance
nor limit i� any way the City's ability to enforce any ordinance
P,OVISIGR�
ENG. INSPECTION FEE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
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I hereby acknowledge that I have read this application; that the
information given Is correct; and that , am the owner, or the duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree With city and
state laws regulating construction; and intodoingmthey work authoriz.
ad 'hereby, no person will be employed In violation of the Labor
Cod a of the State o(14Mton relating to Workmen's Compensa.
tion Insurance ariol , . 7.
!::,1jtC11T1I
FIIIITU,�t,io' I- E SIGNED
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4xR,f,j,
ijjAT._, ..,
THIS PERMIT
T ORIZES
'U "
ONLY T.E
WORK NOTED
111111 INSPECTION
cE IA —ENT
CITY OF
EDMONDS
I
This application is not a permit until
signed by the Building Official or his/her
Deputy; and fees are paid. and receipt is
acknowledged in Space provided.
0 1 FFICf E I DATE
onommEp�
ATTENTION
CALL FOR
INSPECTION
AELE,IEE. BY L," DATE
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING " STRUCTURE
UN711. A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220
ORIGINAL - F,I, YELLOW - r'sprel.,
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
SECTION 109
PINK - Owrer GOLD - Assessor
IN
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ...................
FOUNDATION:
Footing.................
Wall ....... ...............
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'Pier/Porch ..............
RetalnIngW all ...........
0
2,
Slabinsulation ............
Is LUM13ING:
13 IT!
Underground .............
Rough -in .. ........
AM
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Commercial Final ........
10-4
HEATING:
GasTest ................
Gas Piping..
n
. .... ........
Equipment ............. _
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Commercial Final ......
a F)
0
1,
0
EXTERIOR SHEATHING
C
M 0)
NAILING ....................
M C)
FRAMING ....................
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INSULATION:
Floorinsulation ....
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Wall Insulation
cli
Ceiling Insulation .........
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SHEETROCK NAILING ....
0
IT1
SPECIAL INSPECTION . .....
MISCELLANEOUS
FINAL APPROVAL
FOR OCCUPANCY
Acca-S.
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