20020883.pdfLEE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/AFT#
ADDRESS/,,,�/.
OWItER �AMFJNAME OF qUSINESS
PLAT NAMEtSUDDIVISION NO. LUI NO. LID NO.
LID FEE S
MAILING ADDRESS
11
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP A. 1. 1.
EXIS ING — PROPOSED— 13
13
CITY ZIP FE EPHONE
I ..
REQUIRED DEDICATION— FT 13
E
MITER IIIE I LINE SIZE NO, 01 FIXTURES PRV REQUIRED
YES C3 NO
DRESS
HE S
OW`NAERRKICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIORAINAGE
CITY ZIP TELEPHONE
NAME CSL�
7
ENGINEERING REVIEWED By DATE
A;DIIE
I
) I P LIV 'k,
FIRE REVIEWED By DATE M
CITY ZIP TELEPHONE
GIO(,)
BOND
VARIANCEORCU SHORELINE OR Ao-a—# T _INSREEOT
STATE LICENSE NU ER EXPIR ION O� C ED BY
DION
EIYES ONO $ POSTED
7 (
COM SEPA REVIEW SIGN AREA PROPOSED
PLETE EXEMPT ALLOWED PROPOSED ALLOWED
R C OU L
.7 � I M
EXP
SI -(M CT'�
DENTIAL PLUMBIN
LOT OVERAGE REQUIRED 8 BAC .) PROPOSED 8 BAC in I
0 PROP FRONT SIDE BEAR FRONT LIN SIDE
ALLOWE OSED
NEW BI_�_
R
COMPLIANC
r_1 'tQa
0 ADDITION COMMERC L CHANGE OF USE
9
PARKING LOT AREA PLANNING REVIEWED By DATE
B-�EMOOEL MULTIFAMI 0 SIGN
RECH, I PROVIDED
[3 F NCE
0 REPAIR a I _ X_FT)
REMARKS
DEMOLISH 0 TANK C] OTHER
GARAGE ,,,TAINING WALL
.C,EAY FIRE ALARM
L_j GAPPon'r
(TYPE OF USE, BUSINESS OR AGTFJ�7
By TYPE 1 UP
CCU Afij�
CHECKED OF No P
U.SEN
_j H=NAICIEA OCCUPANT
'CIAL INS
aps LOAD
OF
STOR ES
REQUIRE YES
DESCRIBE WORK TO BE DONE
REMARKS
OGRESS INsPEc-noNs PER uBc loo/rINAL I NSPFCTION REar,
Id
I � A I
P
C
HX SOUP I
LOT SLOPE
B
,� 5
j
PLAN CHECK No..
ED DATE
THIS P UTHORNBES ONLY -F WORK NO11D- THIS PERMIT COVERS WORK TO
.,.=A LIC
0. PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUB
DOMAIN joURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
M SEPARATE PERMISSION,
t:
PERMIT APPLICATION: I. DAYS
PERMIT LIMIT I YEjGX . PROVIDED WORK IS STARTED WITHIN ISO DAYS
SEE BACK OF PINK PERMIT MR MORE INFORMATION
*AIPIICANT. ON BEHALF OF HIS OR HER SPOUSE, NOR% ASSIGNS AND SUCCESORS
IN INTZ EST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
AGENTS F OM A NY AND
BE, WASHINGTON� ITS OFFICIALS, EMPLOYEES, AND
2 RUMORR
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDISECILY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
REQUIREMENT OF ANY CITY ORDINANCE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROWSION..
IHERE ACKNOWL90GE THAT I HAVE READ THIS APPLICATIOW THAT THE INFORMATION
BY OF
GIVEN IS CORRECT, AND THAT I AM THE OWNER. ED AGENT
-FEE TO OMP WITH C11 AND S0PArE=AUTH10TR1�`. C.NETRUC-
THE OWNER. I
AND IN DOING THE It, AUTHOR11111 TIENEI NO PERSON WILL BE EMPLOYED
TION;
IN V'OLAT F HE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
�
...X.EN;&.i'ENEATION INSURANCE AND RCW ULM
OR AGENT)
DATE SIGNED
// q161
ALUATION
Description FEE
DesLription FEE
[an Check
State Surcharge
wilding Permit
City Surcharge
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire RevieW
PlanChk.Doposft
Fire Inspection
Receipt If
Landscapeinsp,
Total Amt. Due _55 -
Recording Fee
Receipt #
f
MI cATioN APPROVAL
, n Perm` "Ill sle"ad by Me
CALL a I'd I r��. 0 dF aid. and
FOR INSPECTION ...I 1'..k.-I.d�pdliyls�PnsccePetsmaifd'epd
0 1 , LS I 4ATURE DATE
(425) q 1 0 Z_
771-0220 la BY DATE
ATTENTION r-Al
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CHI INAL - FILE. - YELLOW INSPECTOR
PINK -OWNER - GOLD -ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 GREEN ACCOUNTING
04102 PRESS HARD -YOU ARE MAKING 5 COPIES
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ................
FOUNDATION:
Footing ......................
Wall ..................
Pier/Porch _ ...............
Retaining Wall
Slab Insulation ..........
PLUMBING:
-4
M
C
Underground .. ...........
117111 0
0
-40
Rough -in ...................
0 C
-4 ;C
commercial Final
M z
r) k,
HEATING:
C
Gas Test ...........
Gas Piping :;.; .............
Equipment ..........
Commercial Final
ITI M
EXTERIOR SHEATHING
0 M,
NAILING . ........ ...............
C
FRAMING ...........
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FIRST FLOOR FRAMING
;D
INSULATION ............
Floor Insulation
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Wall Insulation ...........
co
Ceiling Insulation
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0
SHEETROCK NAILING
0
R11
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR...
OCCUPANCY ...............
CCO