20020905.pdfC/
PERMIT EXPIRES
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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STATE LICENSE NUMBER EXPIRATION OAT
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SHORELINE OR ADS. INSPECTION .ON
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RED POSTED
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SIGN AREA HEIGHT
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PROPERTY TAX ACCOUNT PARCEL NO. 11.�
SEPA REVIEW
CON MPT
ALLOW.EDPHOPOSED ALLOWED PROPOSED
EXP
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NEW PLUMBING I MECH
LOT COVERAGE LURE SETBACK$ IFT) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED NTD SIDE BEAR FRONT URSIDE BEAR
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REMARKS
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ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVrM EXPLAIN:
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NUMBER NUMBER OF
OF W a
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STORIES 3 , , UNITS "UMBER
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REQUIRED 0 YES
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LOAD
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DESCRIBE WORK TO BE DONE
REMARKS
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PROGRESS INSPECTIONS PER UBC 1081FINAL INSPEC TION REO'D
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FEE Description FEE
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Plan Check
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HEAT SOURCE LOT SLOPE %
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Building
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CK NO STED DATE
Plumbing
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Mechanical
THIS PERMIT ALITHORRIES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONSON PRIVATE P OPERTY ONLY. ANY CONSTRUCTION ONINE PUBLIC
Grading
Recording Fee
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARMFEIPERM)SISION.
,5t<r, FLAW
City Surcharge
PERIBITAPPLICATION: IWDAYS
PERMIT LIMITI. 1 YEAR - PROVIDED WORK IS STARTED WITHIN red DAYS
in ".."'n
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
tFireRoview
Plan Chk Deposit '71'-1-
'APPLICANIE ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND",
Receipt #
ALL CMMS FOR DAMAGES OF WHATEVE NATURE. ARISING DIRECTLY On INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT UP
Total Amount Due
D EMED TO MODIFY. WAII E OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
NORLIMITINANYWAYTHEC S ABIURYTO ENFORCE ANY ORDINANCE PROVISiOW'
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Receipt #
I HEREBY ACKNOWLEDGE THAT I 14AVE R E THIS APPLICATION; THAT THE UNFORMAI JUN
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNS � I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
spiel sells, 1, net a Potent until signed by Me
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR dUMOF THE STATE OF WASHINGTON RELATINGTO
,,,This
ding Offie�.I,u ble/he, Deputy: end F .. enepid.tend
FOR INSPECTION ,ipllsack ... ledgFull-Facep-ldd.
WORKMEN'S COMP A�11 S F AND ACW 18 27.
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SIGNATURE (OWNER O(AQE_ DATE IGNED
(425)
V4 11111.2—
771-0220
ItEEXA By DATE
ATtENTION
EXT 1333
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING On STRUCTURE UNTIL
771 -0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFL-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
E YELL15 INSPECTOR
PINK -OWNER GOLDWASSESSOR
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A FAN P
VgR UNIFORM SUILoING CODE SECTION 149
At: Building Permit #,
by this coolcate: Dwellin Units: **NA** % No. Stories: 3
Occupancy established
771tatructionA-21rir Sprink, Basement: Yes
B Ty ruction:11
maximum Qccupent Lead sr�.U.S.C. 1002)
Roorrtioopa* sAwps,
es.
98026
Owner of Building:
PP TION OF THE
HAS BEEN INSPE UIREMENTS OF THE 122LEDI
THE _CA&AMtJJSQM OCCUPANC
0 ADOPTED By FO Y AND THE USE FOR WHICH THE
UNIFORM BUILDING CODE A
PROPOSED OCCUPANCY 18 CLAS81FIE1
...........
Issued this 0
CHIEF BUILOW OFFICIAL
BY:
Anychanipcf=UPQnCYOtuwMUIMRbUldingPOMItAnds�m
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MENIO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE_ 1�
ENGINEERING DIVISION DATE
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PLANNING DIVISION DATE-
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PROJECT A4 6 13 Z /'-ox 111c_nv
SITE ADDRESS _2?9�,a 2/ 6 z 425� 2:30
am
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PERmrr #'200,2 -0 9os ADB#-------PATE INSPECTED
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DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine final compliance with approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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u Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date----- Si
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS
FOUNDATION:
Feeling ................
wall .................
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Pier/Porch . ..............
Retaining Wall
Slab Insulation ..........
PLUMBING:
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Underground
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Rough -In ..................
Commercial Final
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HEATING:
Gas Test ..............
Gas Piping .................
Equipment
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.................
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Commercial Final
EXTERIOR SHEATHING
NAILING ............
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FRAMING ......................
FIRST FLOOR FRAMING
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INSULATION ...................
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Floor Insulation
Wall Insulation . ..........
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Ceiling Insulation
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SHEETROCK NAILING
IT
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
u_ 1-7
OCCUPANCY ..................