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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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ARKS 1
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CON FROL:/:D:M:�[�NAGE 1
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STATE LICENSE NUMBER EXPIRATION DATE I 6EC 6
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ANCE OR CU I
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ALLOWED PROPOSED
REQUIRED SETBACKS lFT. PROPOSED
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REPAIR GRADING CYCE
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NUMBER OF
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REMARKS
PROGRESS INSPECTIONS PER UBC 10S/FINAL INSPECTION REOD Ei
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Description FEE
Description FEE
Plan Check
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State Surcharge
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Building Permit
City Surcharge
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PLAN CHECT.7 VESTED DATE
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Plumbing - 4
THIS PERMIT AUTHORIZES ONLY THE W RK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
t: HE DONE ON PRIVATE PROPERTY ONLX ANY CONSY UCTION ON THE PUBLIC
Grading
Do MAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
3
BE MIT APPLICATION; ISO DAYS
Engr. Review
PERMIT LIMM. I YEAR - PROVI ED WORK IS STARTED WITHIN 160 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
IPPLICANI. 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
US'
IEDMON WAIHINOTON, ITS OFICIALS, EMPLOYEES, AND A13INTI FROM ANY
AND
ALLC WMS RECTLY
FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDHO
Fire inspection
Receipt #
FROM THE ISSUA OE OF THIS PERMIT ISSUANCE Or THIS PERMIT SHALL I BE
DEEMED TO MODIFY' WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapeinsp.
Total Amt. Due
0 NOR LIMIT IN ANY WAY THE Cl a ABILITY TO ENFORCE ANY ORDINANCE PROVISION,.
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAV READ TH S APPLICATION THAT THE INFORMATION
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-
app] 1111-lanot a ponaftlatil signed by did
CALL
TIOW AND IN DOING THE Won RSON WILL BE EMPLOYED
IN VIOLATION OF THE LAC��HTATE PC PE
EReBy6N WASHINGTON REIATING TO
SvitThis
FOR INSPECTION nine
Olfic:al or his/her De,mly: and Fees am paid, and
-.1" is sloi-magmI In tma�,75.
WORKMENS COMPENSATIO NCE AN RCW H3,27.
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SIGNATURE (OWNER OR JdQENTj___---� DATE
(425)
'SIGNED
771 '0220 tLE
F DATE
AVENTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
I,__ � OAK 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
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DEPARTMENT OF BUILDINGS UP
PER UNIFORM BUILDING CODE SECTION 109
At:— 7320 210' St SW #100 Edmonds, WA 98 26 Building Permit #: 2002-0973
Occupancy established by this certificate: Dwelling Units: -N/A** No. Stories: 3
B Type;Construction. 11 1HR Sprink Basement: Yes
Maximum Occupant Load --49-- (Per U.B.C. 1002)
Room capacity signs, whe,!,7 re(JUIre�,L all times.
must remain posted I
Owner of Building: Stevens Medic 1 Offic4 Bulidind
4 . ress: `i�§20 21t litswildmonds WA 98026
THE Hadfleld Pharmacy AS BEEN INSPECTED AND �PPROYED,.- SCOMPLYING WITH THE REQUIREMENTS OF THE 1997 EDITION OF
E
THE UNIFORM BUILDING CODE AS ADOPT D BY THE CITY TOR�Tjft GROUI� AND DIVISION OF OCCUPANCY AND THE USE FOR WH CH THE
PROPOSED OCCUPANCY IS Cl ASSIFIED.
Issued this '17th day'ofjiune, 2003
CHIEF BUILDING OFFICIAL
BY:—
Thl, -0ficat-b.11 be posted In e cooploo., pubIld am and 31ball not be —ow1d, anotitaled a, obecom and sholl ba-lowned 1. 111bl. booddion,da too... Anyoong—f—p—y ..... . qn0onsebAldingp.ondand.—
Ceffoate ofOco,paoWaabed by the a1yof Ed000nds Sodding Officlal.
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APPROVAL ARM
FINW PROJECT
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FIRE DEPARTMENT DATE �f— Q
FROM: 14;121 —Lf
ENGINEERING DIVISION DATE —
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PLANNING DIVISION DATE
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PERMIT #2�0�0— '��ADB# C-12-o
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DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine final compliance with approved plans. Final approval
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
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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a Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
o Copy of CORRE CTION NOTICE given to owner/contractor by inspector
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RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date_ Sign
ocaprv1.doc.1:temp:b1dg:fbnns 10/0 1
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ...........
Wall_ .......................
Pier/Porch ................
Retaining Wall
Stab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
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Commercial Final
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C
HEATING:
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Gas Test ....................
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Gas Piping ...............
10
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Equipment .............
Commercial Final
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EXTERIOR SHEATHING
NAILING ...........
MITI
FRAMING ................
0
FIRST FLOOR FRAMING_
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INSULATION ...........
4
Floor Insulation
Wall Insulation
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Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY .............