20020899.pdfDATE RECEIVED
PERMITIEXPIRES
USE PERMIT hy),?_
ZONE I
CITY OF EDMONDS L-;_�12 Z' NUMBER
CONSTRUCTION PERMIT APPLICATION JOB SUIT
7WNI]n USINESS ADDRESS �_j
PLAT NAMEISUBDIVISION NO, LID 0.
L�D
MAILING ADDRESS 0 FEE $
PUBLIC FIKRIT .1 WAY PER OFFICIAL ....T MAP R==4"
7_3 -7 A,)-( I se— Us. FRI,
CITY zip �LE;ONF EXISTING — PROPOSED— 'Rep" s ' R
REQUIRED DEDICATION— FT — U"
A A A 2 32-i
15
I
!A
ADDRESS I _J
qQ12-5 ti) VI-1a WA_ r)
(&� nj I-
FINE "' 'EWey
DATE
or
B or L velit connectors
—.9—
STATE LICENSE NUMBER EXPIRATION DATE CHECXED BY
VATUANH E 0
OR
POS, ED
spaces. U MSYMPISINO.
rh r- k-.v- z't'ro P 1)
1
$
PRO ... A Go NO.
SEI rRMW--
COMPLETE EXEMPT ALLOWED ALLOWED IIIOPO�ED
I PROPOSED
3PARCEL
0030 00
E XF
LOT COVERAGE
REQUIRED SETBACKS (FT.) PROPOSED SETBACKS IFT)
NEW RESIDENTIAL O<U..N.I.EC.
ALLOWED PROPOSED FRONT SIDE REAJI FRONT IJRSIDE REAR
ADDITION C MPLLANCE OR
COMMERCIAL C.AN.E.FUS.
PARKING
I LOT AREA PLANNING REVIEWED BY DATE
rl REMODEL MULTIFAMILY SIGN
REG 0 1 PROVIDED
REPAIR GRADING M F NCE
Cyos I — X_FT)
REMARKS
M DEMOLISH rl TANK n OTHER
0 GARAGE o AFTAININOWALL F RE SPRINKLER
se
CARPORT ROOKERY FIREALARM
(TYPE OF USE. SUJINESS OR ACTAZ EXPLAIN:
r. ve-C,
CHECKEDBY ITYP
ECUPANT
cup
ME: CT-3 00
HOME N MEER OF CRITICAL
OF 0 ING ARIAS
11FECIALINSPECTIOIN
00cu w
PA
0
U
STORIES UNITS NUMBER
DESCRIBE WORK TO BE DONE
REQUIRED yE
JAREA
LOAD
H MARKS
PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REOD
�m P
'0;)0 VT7) 1i
VALUATION
VA L UAT
$
cir"ON
ption
Description
D
FEE Description FEE
'an ,-;,
Plan Check
State Surcharge
I,
GLAZING % LOT SLOPE %
rGrading
Building Permit
-UhId'n. Permit
City Surcharge
PLAN CHECK NO: 'STED DATE
"Um 'IT
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
b: BEDONEON PRIVATE P GREEN ONLY. ANY CONSTRUCTION ON THE PUBLIC
:3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
RE MITAPPLICATION: 180DAYS
PERMIT UMm I YEAR - PROVID D WORK IS STARTED WITHIN ISO DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHAL HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
I
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
nmoNDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt #
FROM THE ISSUA CE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT OF
DEEMS n' MODIFY' WAIVE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINANCE
Landscapoinsp.
Total Amt. Due
�a
0 NOR LIMIT IN ANY WAY THE CrTYS ABILITY TO ENFORCE ANY ORDINANCE N.'
PROVISIO
Recording Fee
ipt #
la),1110
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
TO OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
CALL
This applicallan IS-1 a pe-ft will siglod by the
1"ildhp OlficlIl e, hIsIhI, DSP.ly: ORR Few— peld, Sell
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WAS14INGTON RELATING TO
FOR INSPECTION _WPI IS.CknwISd9.d I. sp ... TRSAII.IL
WORIMENS COMIENSAAT2 fi�RANCE AND RCVy 18,27.
O�Fhcl '7 DATE
(OWNI,=
(425)
v,TPRE
771-0220 'RE[EA"
&A14
'DAM
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
I
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE , YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
PINK -OWNER - GO D-ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
z
C: In
a I I
0
80
C:
--I C
= rn
IT Z
0 D
It
1111 In
a ra
or -
OM
C CO
C 0)
IT C)
Z
X
z
z
0
0
In
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing
rw
Wall .....................
Pier/Porch ................
Retaining Wall
M,
Stab Insulation
PLUMBING:
Underground .............
IT
C
IT
Rough -in .............
0
0
Commercial Final-
3: m
HEATING:
ITI
10
C
Gas Test .............
>
r
Gas Piping ...........
Equipment ...........
0,n
n
Commercial Final
rn M
EXTERIOR SHEATHING
NAILING .............. ...........
0
0 fn
C: 0)
C CA
FRAMING .................
rR 0
FIRST FLOOR FRAMING—
z
.4
INSULATION ......... .........
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
z
SHEETROCK NAILING
SPECIAL INSPECTION
ITI
MISCELLANEOUS
FINAL APPROVAL FOR
i.
OCCUPANCY .................
0wo I ftw