20020861.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPUCATION
OWNER NAMEINAME OF BUSINESS
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PERMIT EXPIRES
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NUMBER 2002- - 0�& I
JOB SUITE[APT#
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PLAT NAME/SUBDIVISION NO.
LOT NO.
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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EXIST No - PROPOSED-
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METER SIZE
LINE SIZE
No, OF FIXTURES
PRV REQUIRED
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0 NO 13
REMARKS
OWNERICONTRAGMA AP-NaIRLE FOR EROSION CONTROUDRAINAGE
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FIT,- -4- ZIP FIRE REVIEWED BY DATE
TELEPHONE
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STATE LICENSE NUMBER EXPIRATION DATE KED By VARIANCE OR CU 08 ADS# INSPE(
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COM BETA REVIEW I ALLO SIGN AINEA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. PLETE EXEMPT WED I PROPOSED ALLOWED , PROPOSED
-7 EXP 40 it /s, Ive
OT COVERAGE I REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.)
NEW RESIDENTIAL OPLUMBINGIMECH L FRO NT SIDE BEAR FRONT UPSIDE REAR
ALIOWEI) PROPOSED
rl ADDITION COMMERCIAL C MPLIANCE R
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PARKING LOT AREA P NNING REVIF�MWED DATE
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NUMBER NUMBER A
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0, OWELLINO AREA SPECIAL INSPECTION OCCUPANT
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'TORIES _3 UNITS NUM.En' REQUIRED [3 YES
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DESCRIBE wonK TO BE DONE
REMARKS
-PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REa
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VALUATION
(2-120 e4z)
Description
FEE Description FEE
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Plan Check
State Surcharge
HEAT SOURCE GLAZING LOT SLOPE %
Building Permit
City Surcharge
PLAN CHECK 7fZ VESTED DATE
Plumbing
:�r
Mechanical
THIS PEANUT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: B DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDENYALKS, DRIVEWAYS, MARQUEES. EPC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PER TrAPPLICATION: INDAYS
PERMIT LIMIT. I YEAR - PROVI ED WORK is STARTED WITHIN 1 60 DAYS
Engr. Inspection
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
RE
IN INTE E AGREES TO INDEMNIF`X DEFEND AND HOLD HARMLESS THE CITY OF
E D IONDS. WASHINGTON, TS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt III
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
X FROM THE ISSUANCE 01 THIS PERMIT ISSUANCE OF THIS PERMT SHALL NOT BE
9 DEEMED TO MODIFY, WA VE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp.
Total Amt. Due
0. NOR LIMIT IN ANY WAY THE CITY$ ABIUTY TO ENFORCE ANY 011INANCE PROVISION. -
Recording Fee
Receipt #
I HERESY ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
T E OWNER. I AGREE To COMPLY WfTif CITY AND STATE LAWS REGULATING CONSTnUC_
CALL
ThIsprel cation Is not a racent-11 signed try en,
TION. AND IN DOING THE WORK AUTHORIZED T EFIESY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
Bud ding Offic�ai or atener Deptay: and Fees am paid, and
FOR INSPECTION receipt is ark -lodged in space Presided,
WORKMENS COMPENSATION INSURANCE AND RCW 18,27.
DATE
SIGNATUREM;T!P
(425)
SMMJ
771-0220
A LEA ED BY ATE
ATTENTION
EXT 1333
IT IS UNLAWFUL To USE 08 OCCUPY A BUILDING OR STRUCTURE UNTIL
4
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINI��FA YELLW. flNS1ECTO
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PNK HER 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 ..........................
PiedPorch
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Retaining Wall ...........
0
M
Slab Insulation;
PLUMBING:
Underground .............
M
0
Rough -in ..........
Commercial Final
-4 c
HEATING:
= M
In
Gas Test ................
>
Gas Piping ..............
Equipment ...........
Commetcial Final
M M
EXTERIOR SHEATHING
0 r
NAILING ..........................
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FRAMING ..............
co
M C)
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
z
Wall Insulation
Ceiling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
ITI
MISCELLANEOUS ..........
FINAL APPROVAL FOR -03
OCCUPANCY ..................