20020855.pdfDATE RECEIVED
PERMIT EXPIRES
H E
PERMIT
CITY OF EDMONDS
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ILICATION
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
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NAME
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PRY SQUIRED
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ADDRESS
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NAME JC5L I ENCINEEFIN. FEVRiWE. BY DATE
ADDRESS
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CITY ZIP TELEPHONE
STATE LICENSE NUMBER EXPIRATION AT CHECKED d.Y VARIANCE OR CU I IH6RELINEORADBN I INSPECTION IS
REaD
OYES ONO
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COMPLETE , 11IMPT
EXP
A110VVE0 , PROPOSED
AL-111
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (7.)
0 NEW
'5�71EIIDINTIAL
PLUMBING/MeCH
ALLOWED PROPOSED FRONT SIDE FEAR FRONT U11 SIDI FEAR
ADDITION
0 COMMERCI AL
COMPLIANCE OR
CHANGE OF USE
W.E.A.11S
REMODEL
ULT'F'.�Ly
0 M7
0 SIGN
LOT AREA PLANNING REVIEWED BY DATE
RIGID PROVIDED
REPAIR
E] GRADING
CYOS
FENCE
171 ( _X_FQ
0 DEMOLISH
rl TANK
OTHER
E:iGARAGE
0 RETAININGWALL
Fin SPRINKLES
CARPORT ROOKERY
(TYPE OF,� SUSINE S OR TIVITY) EXPLAIN:
FIREALARM_
_ F.
i
- CHECKED S2PE AUU1014
NUMBER
OF -Z
NUMBER OF
I WELLING
RITICAL
A R
OCCU NT
STORIES
UNITS
NU
LOAD
DESCRIBE WORK TO BE
DONE
REMARKS
PROGRESS INSPECTIONS PER USC 1081FINAL IN
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De scription
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FEE
Description
FEE
Plan Check
Pla
State Surcharge
HEAT SOURCE OWING % LOT SLOPE %
Building Permit
City Surcharge
ESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHOR-6 OLLYTHEWORK NOTED. THIS PERMIT COVERS WCNIKTO
t: 0 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION,
Engr. RevieW
PE MIT APPLICATION: IN DAYS
T PERMIT LIMM I YEAR-PROVI go WORK IS STARTED WITHIN '80 DAYS
Engr. Inspection
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS. A11113NI AND SUGCE�OFS
Fire fhevie�
Plan Chic Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS' WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE , ARIS NG DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapeinsp.
Total Amt. [)us
DEEMED TO MODIFY, WAIV OR REDUCE ANY REQUIREMENT OF ANY CITY ORDdINANCE
0 y , I R. C
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION -
X1
Recording Fee
Receipt #
I I EREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE IN, ""AH".
AGENT
APPLICI APPROVA L
GIVE IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
1.� nt - fmit Inti aled by Ble
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
So
�i �'o es
1%ohlI.0 Iy:.,,di!i pald.and
N VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
odInsp,qpW,,IdN,
WORKMENS INSURANCE AND RCW 18.27�
OFF]
SIGNAT
D E SIGNED
(425)
771-0220
REI
ENTION
M 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK�OVVNEA GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GSEF.N.ACCOUWINr
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing .................
Wall ....................
Pier/Porch .................
z
Retaining Wall
0
Stab Insulation
PLUMBING:
Underground ..........
M
C I
Rough -In .. .................
IT!
0
commercial Final
0
HEATING:
Gas Test
Gas Piping .............. . .
Equipment ............
0
n
Commercial Final
ITI M
EXTERIOR SHEATHING
NAILING ..........................
0
6 Fn
FRAMING ..............
C (A
FIRST FLOOR FRAMING
M 0
(4-0
INSULATION _ ...............
Floor Insulation
Wall Insulation ...........
z
Coiling Insulation
1;-7 - o3
z
SHEETROCK NAILING
SPECIAL INSPECTION
171
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..............