20020961.pdfDATE RECEIVT_)
PERMIT EXPIRES
us' PERMIT
CITY OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION JOURES2
ADD 111TE11
OWNER NAMEMIE OF BUSINESS
44 PLAT NAME/SUBDIVISION NO. _F77NO 10 NO�
MAILING ADDRESS LID FEE $
PU.U. RIGHT OF 1E. OFFICIAL STREET' MAP
F, :Zj
CITY EXISTING - PROPOSED -
ZIP a
,,,,�TELIPIIIIE REQUIRED DEDICATION- FT 13
LQ :2 ) ---- [--;T-
NAME METER SIZE I LINE Slii D, OF FIXTURES PRV REQUIRED
YEst3 No E3
ADDRESS REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTR�LIDRAINAGE
CITY
L vent enn
NAME
ENGINr 7
�DDRESS
Alk'
FINE REVIEWED BY DATE
TELEPHONE
'�ff* -')U-
rTATE LICENSE NUMBER
EXPIRATION DATE
I CHECKED BY
V RIANCEORCU
SHORELINE OR ADBY
'I'D a'
RELINE OR AD
INSPECTION
INSPECTION
RED 0
FIECO
POSTED
1. BOND
S
0YEs ONG
2-J
L
$EPA REVIEW
SIGN AREA
HEIGHT
ROPERTY TAX ACCOUNT PARCEL NO.
C MPLETE EXEMPT ALLOWED PROPOSED
ALLOWED PROP09ED
ALL.'
E-S
,
E] NEW
Y_0E.I.EN`n-
P§:;IUMBINGIMECH
LOT C EFIAGE REQUIRED SETBACKS LIFIL
ALLOWED OVPROPOSEO FROM SIDE BEAR
AL
PROPOSED 8 TBACKS (IT.)
'ROPO
FRONT UR'SIDE BEAR
no_
ADDITION
rl COMMERCIAL
COMPLIA14CE OR
M CHANGE OF USE
�OEMODEL
MULTIFAMILY
SIGN
PARKING
REDD I PROVIDED
JE
LOT AREA
PLANNING REVI BED By DATE
LA
REPAIR
GRADING CyDS`
FENCE
0 1 X Fn
REMARKS
DEMOLISH
TANK
OTHER
AGE
RETAININOWALL
F PC SPRINKLER
EGA
I CARPORT
ROCKERY
FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
'I_
CHECKED BY
T
GO UPA NT
M
JTNP��
GROUP
NUMBER
OF
HUM ER OF
G ELLING
CRITICAL
AREAS
I
IPICIALINIPECTION
6666PANT
NITS
NUMBER
I REQUIRED 0 YES
JAIIA
I
LOAD
STORIES U
DESCRIBE WORK TO BE DONE
-11 PROGRESS INSPECTIONS PER usic los/rINAL INSPECTION REO'D I
VALUATION
'Aa I'- AIN ZO mm-
$
MQ V�pjkj
Description
FEE
Description
FEE
I 1 0
9
Plan Check
p
State Surcharge
BL."
HEAT SOURCE GLAZING I LOT SLOPE 11
Building Permit
City Surcharge
PLAN CHECK NO:
Plumbing
P
Mechanical
THIS PERMIT AUT ORIZES ONLY 1.a WORK NOTED. THIS PERMIT COVERS WORK TO
1110"1 ON 11111 PROPERTY ONLY. ANY 00145111111011 IN THE PUBLIC
Grading
DOMAIN ICURSS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WI LL REQUIRE
SEPARATE PERMISSIOhL
Engr. Review
IPERMLIAPPLICATION: I.DAIS
PERMIT LIM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
%PILI I,ONIEHAIFO HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
CA L
Fire Review
Plan Chk, Deposit
114 INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
E MONDS. WASHINGTON, IT OFFICIALS, EMPLOYEES. AND AGENTS FROM ANYAND
0
Fire Inspection
Receipt #
ALL CLAIMS FO DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT HE
NANCE
Landscapeinsp.
andsc
Total Amt. Due
DEEMED TO MODIFX IVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDR
'OR LIMIT IN ANY THE OnYa ABILITY TO ENFORCE ANY ORDINANCE PROWSION.'
tRrd
_
Recording Fee
Receipt #
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
1, A I N APPROVAL
GIVEN is CORRECT� A D THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
E E COMPLY WITH CITY AND STATE LAWS REGULATING CONST
Id a .�rananldald aiBadd V, a
n'�
THEOWNER. iAGR TO
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPUDIUED
CALL
I na, on'Iny; F.dd PaId , and
nI 'LI
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN OMPEN - I NSURANCE AND RCW 18,27.
FOR INSPECTION a$ JJsj,!k .. Iedgodl p COP-ided,
A URE
-.e�l! URE E
1 DATE SIGNED
(425)
771-0220
�Az_
By f DATE
ATTENTION
EXT'1333
1,7
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
I
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL Oil A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK-OWNFR - GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
z
0
4 . I
0
M
ITI
0
80
C
M
10
CA
0 -n
III
--i
x
M M
055
0
6 Fn
a ca
C (j)
IR 0
z
.A�
ID
z
co
z
9
0
Ph
Pier/Porch . ..........
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
M
Underground .............
IT!
0
0
Rough
-in ...................
ITI
Commercial Final
z
JE) —1
HE ATING:
Gas test ....................
CA
Gas Piping .................
0
Equipment .................
M M
Commercial Final
0
EXTERIOR SHEATHING
0
C:
NAILING .........................
C U)
Q 0
FRAMING ........................
Z
FIRST FLOOR FRAMING
INSULATION ...................
z
Floor Insulation
Wall Insulation ...........
z
Ceiling Insulation
9
0
SHEETROCK NAILING
IT!
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
&d
OCCUPANCY ..............