20020926.pdf— DATE RECEIVED
L
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWN'
1�11MFIJWIM 01 BUSINESS
00 C�
I.- MAILINGADDRESS
I Ac W
CITY ZIP TELEPHONE
rl NAME
PERMIT EXPIRES�U�Aw
USE
.NE PERMIT
NU,IER,-,?ZW
JOB ITE/APT#
ADDRESSC"Ca6 &P1_ ZO
PLAT NAMEISUBDIVISION NO.
LOT 110.
IL*�D 110,
I
IT FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
W P=
EXISTING — PROPOSED
REQUIRED DEDICATION— FF
METER SIZE
LINE Sll.�
No .1 FIXTURES
PRV REQUIRED
I
YES E3 NO C3
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
CITY ZIP
IT111PHON1 FlHt MARSHA . L
I 1`9R
NAME __TC8L# MUST M PRESENT
"k CAP.
OVIN DATE
ENGINEERING ayi, I
ADDRESS
FIRE REVIEWED By DATE
CITY
lZ
VARIANCEORCLI I SHOFIELINIORAD81 I INSPECTION BOND
STATE LICENSE NUMBER EXPIRATION RECTO F.STE.
11 E3YES ONO S
I SIGN AREA HEIGHT
PIPE COMPLETE EXEMPT ALLOWED IR01111E. I ALLOWED 1R.FOSED
EXP I , ,
11 NEW RESIDENJTIAL PLUMBINGIMECH LOT C VERAGE REQUIRED, SETBAC S (FT.) KS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FR
ADDITION COMMERCIAL COMPLIA CE OR
C"ANGFOFUS5
r
EWED BY DATE
REMODEL MULTIFAMILY 13 SIGN
0
0 REPAIR GRADING CYDS FfE Ce x FF) REMARKS
[3 DEMOLISH Z TANK OTHER
cGARAGE o RETAININGWALL F RE SPRINKLER
CARPORT ROOKERY FIREALARM
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
CHECKED BY ITYP O.COCUPA
. UP
�N11Tkr1lON
NUMBER 'ABER OF ITICA
NNITS 'N'UMERL/V/A
�0(c
OF DWELLING AREAS -P REA OCCUPANT
[REMA
STORIES -E�' LOAD
D BE WORK ITO E DONE
KS
ROGRESS INSPECTIONS PER USIC 10811FINAL INSPECTION REOD
P.
Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE LOT SLOPE
Building Permit
City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE ORK NOTED. THIS PERMIT COVERS WORK TO
I: REDONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ONTHE PUBLIC
Grading
3 0 O"IN (CURBS, SIDEWALKS.DINVEWAYS MARQUEES, ETC.) WILL REQUIRE
PERM;
SEPARATE ItSion. —
PEFIMITAPPUCATION: INDAYS
Engr. Review
PERMIT LIMIT I YEAR -PROVI ED WORK IS STARTED WITHIN 1 00 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLIO T* ON BEHALF OF HIS OR HER SPOUSE� HEIRS. ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
—
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
I Receipt #
IALLCLAIMSFO DAMAGES OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE F THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY. WAIVE OR REDU E ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapeinsp.
Arm, Due
2 NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
— .
Recording Fee
Receipt #
I HEREBY ACKNOWLE BE THAT I HAVE READ THIS APPLICATION� THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER. On THE DULY AUTHORIZED AGENT OF
S LA 'UA G CONSTRUC.
R WIT ""
THE OWNE . I AGREE TO COMPLY WITH GITY AND
CALL
rhi, "vicati- Is not a pe"ll until signed by Ine
XTA .
. T. E N
Tiot 4; AND IN DOING THE WOR"Un"'O"I B . PERSON WILIN.E EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE ETA , WAs.KTI.TQN BELAYING TO
FOR INSPECTION
8.11,11.g Offid.1 In, hhtft, D.puly: nd F In. ptild, no
n,ulpll...k.-I.dg,,dlniip p—id,,d,
wo Art SURANCE AND no
"IN T ne�
DATE/il;
(425)
WY
�_S_ VNURE"r N
771-0220
1 k
UELEASEL"
0 DATt
ATTtNTION
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-
ORGINAL-FILE - YELLOW, INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER - GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE
MAKING 5 COPIES GREEN � ACCOUNTING
z
0
M
Mini
0
0
a
3: In
R11
0
CE
CO
o
IT
rn ITT
0
5
C
K coo
M 0
Z r-
X
-4
0)
z
0
4
0
171
f
........... . ... . ...... ..
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETSACK$ ..........
FOUNDATION:
Footing
wall ........... ..............
Pier/Porch
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING;
Gas Test ..............
Gas Piping
Equipment
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ...............
FIRST FLOOR FRAMING
INSULATION ...........
Floor Insulation
Wall Insulation
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR_
OCCUPANCY ...............
I
10
C
ITI