20020854.pdfDATE RECEIV 7 /1 AROA
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CITY OF EDMONDS ZUONE PERMIT
CONSTRUCTION PERMIT APPLICATION do NUMBER
OWNER NAMEINAME OF BUSINESS ADDRESS Nu I C,
PLAT NAMEISUSDIVISION NO7 '['Tj L�D NO.
MAILZ ADD�iE_S� L D FEE I
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ZIP NONE EXISTING — pR Posen_ J=_ S
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RESS I OR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
ADDRESS
CITY
ZIP TFIEIIIONI
FIRE REVIEWED BY DATE
STATE LICENSE NUMBER EXPIRATION
VAF31ANCEORCU SHORELINE OR ADE1 INSPECTION IS SONDO
REGID POSTS
13YES ONO
4 PROPS OU PARCEL NO.
$EPA REVI SIGN 111Aj HEIGHT
COMPLETE EXEMPT I ALLOWED PROPOSED ALLOWED PROPOSED
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EXP , , I
NEW
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LOT COVERAGE RE RED SETBACKS (FT.) PROPOSED SETBACKS RT)
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
I
C] ADDITION
El COMMERCIAL
REMODEL
MULTIFAMILY
SIGN
PARKING I LOT AREA LANISN. REVIEWED BY DATE
RECID I PROVIDED
REPAIR
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REMARKS
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o GARAGE
CARPORT
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(TYPE OF USE. BUSINESS EXPLAIN:
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DESCRIBE WORK TO BE DONE
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REMARKS
PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION IREO'D
$
Description
F
FEE Description FEE
VPIanChmk
State Surcharge
GLAZING % LOT SLOPE %
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Building Permit
City Surcharge
PLAN CHECK NO: -Sti —IE
Plumbing
PILOT"",.
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WOnK NOTED. THIS PERMIT COVERS WORK TO
HE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
Grading
0 DODMUN (CUSSRS, SIDEWALKS, DRIVEWAYS MAROUE'S, ETC,) WILL REQUIRE
SEPARATE PERMiSSION.
PE MITAPPUCATION: IOODAYS
Engr. Revievv
PERMIT LIMIT, I YEAR - PROVIDED WORK 15 STAITTED WITHIN ISO DAYS
Engr. Inspection
SEEOACKOFPINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCC17SORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt III
ALL CLAIM' 10" DAMAGES OF WHAIIIEG ...E AMBING DIRECTLY OR INDIRECTLY
FROM TNE'SEUANCE OF THIS PERMIT. SSUANCi OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY
Landscapeinsp.
Total Amt. Due
REQUIREMENT 01 ANY ITYORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Race ml ng Fee
Receipt If
IAT
I HERESY ACKNOWLEDGE Ti I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT AM THE OWNER, OR IRS OULY AUTHORIZED AGENT OF
- -
APPLICATION APPROVAL
THE OWNER. I AGREE To COMPLY WITH CITY 1114D STATE LAWS REGULATING CONSTRUC-
TION: IN DOING
CALL
TKd 0 it adi signed by Ind
AND THE WORK AUTH RIZED THEREBY, NO PERSON WILL BE EMPLOYED
LAUDS 0
IN VIOLATION OF THE CODE OF THE STATE OF WASHINOTON RELATING TO
that Op�m: andi2olim am paid, and
FOR INSPECTION r-1;fpk1 e`�'=Mad.ed i,,p .. pmidinl,
WO XMsN` SUSAN
WORKM Nr��SATI N IN CE AND RCW 16,27,
SIG]tJ E
(425)
.11ii IAL I . TU IF ATE
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,
1 1� / I 'y
771-0220
1yA11D BY DATE
ATTENTION
EXT 1333
IT IS UNLNiAfFUL 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
Oniul' AL IS - YELLOW - INSPECTOR
PINKN Q: R - GOLD -ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS . ...................
FOUNDATION:
Footing ............
wall............ I .............
Pier/Porch .................
Retaining Wall ...........
Slab Insulation
PLUMBING:
Underground .............
Rough -in ...................
TR
C 1A
M
Commercial Final
0
C
HEATING:
M
GasTest ..............
Gas Piping
0
Equipment .................
0
Commercial Final
EXTERIOR SHEATHING
M M
NAILING ........................
ca
0
FRAMING
0
C M
ch
FIRST FLOOR FRAMING
M 0
INSULATION ..................
ZI
Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................