20020890.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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NUMBER
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FLAT NAME/SUBDIVISION NO. LOT NO, Lit NO,
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REVIEWED DATE
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LOT COVERAGE REQUIRED SETaAcKs (Fr.) PROPOSED SETBACKS ITT)
ALLOWED PROPOSED FRONT SID BEAR FRONT URSIDE BEAR
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INSPECTIONS PER UBC 108/FINAL INSPECTION REDD
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Description
FEE Description FEE
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Plan Check
State Surcharge
HEAT SOURCE GLAZING %
LOT SLOPE I
Building Permit
City Surcharge
PLAN CHECK NO:
—
VESTED DATE
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THIS PERMIT AUTHORIZES ONLY THE W RIC NOTED. THIS PERMIT COVE —
S WORK TO
Mechanical
2
B DONE ON PRIVATE PROPERTY ONOUL ANY CONSTRUCTION ON THE" PUBLIC
Grading
3
Be
MALIN (CURBS. SIDEWALKS, DRIVEWAYS, MAR
a OUEES'ETC.) WILL REQUIRE
SEPARATE PERMISSION.
2
Engr. Review
M
PER ITAPPLICATION: IN DAYS
A.
PERMIT 1.00r. I YEAR - PROVIDED WORK IS STARTED WITHIN IN DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON IIE-11 011115 OR HER SPOUSE. EI.S. ASE1.1,I. AND I.ICCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST AGREES TO INDEMNIFY. DEFEND AND 14OLD HARMLESS III CITY 11
EDMONDS. WASHINGTON ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLARDS
Fire Inspection
Receipt #
FOR OAMAGEB 01 WHATEVER NATURE, A""'"" IIIITECTLY 118 INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF My CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABIL17Y TO ENFORCE ANY ORDINANCE PROVISION,'
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Total Amt. Due
Recording Fee I
Receipt #
I HERESY ACKNC L IIG THAT I HAVE REA. THIS APPLICATION: THAT THE INFORMATION
W
G RVEN CORR�CT.�.. RAT AM THE OWNER, OR THE DULY AUTHOR ZED AGENT OF
APPLICATION APPROVAL
OMPLY WITH CITY AND STATE LAWS REGUIATING CONSTRUC.
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�A WILL BE EMPLOYED
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,T 04NSUFIANCE AD RCW 18.27.
FOR INSPECTION
DATE ED
(425)
OFFICIALS IS G U DATE
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ATTENTION
771-0220
EXT 1333
IT IS UNLAWFUL 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
OS�INAL NLE - YELLOW. INSPECTOR
04/02 PRESS HARD -YOU ARE
P;NK.OWNEH - GOLO-ASSC�SSOR
MAKING 5 COPIES GREEN, ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ............
Wall .; ........... .............
Pier/Porch
Wall
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Retaining ...........
-4
Slab Insulation ..........
PLUMBING:
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Underground .............
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0
0
Commercial Final
C
HEATING:
M
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Gas Test ....................
Gas Piping .............. . .
Equipment .................
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Commercial Final
EXTERIOR SHEATHING
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NAILING ........................
0
0 Fn
FRAMING ............... 1
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FIRST FLOOR FRAMING
INSULATION ...........
Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
0
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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