20020976.pdfDATE RECEIVED PERMIT EXPIRES
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CITY OF EDMONDS ZONE
CONSTRUCTION PERMIT APPLICATION 300 SUITEI
ADDRESS
OWNER NAMEINAMFF BU�Ess If -) . --- —
PLAT NAMESUBDIVISION NO, NO. L
L�13 NO.
MAILING ADDRESS 7 _!LD F E S
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P PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
ULQ RIGHT OF WAY PER OFFICIAL STREET MAP =,RK 13
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ADDRESS REMARKS
-NERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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Description
FEE
Description
—
FEE
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Plan Check
State Surcharge
HWURC E GLAZING % LOT SLOPE %
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Building Permit
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PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THISPERMITAUT ORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORKTO
11101, ON P1111 PROPERTY ..I.I. ANY C.HISTAUCTI-14 ON 'HE PUBLIC
Grading
DOMAIN jCURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WI LL11EQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: INDAYS
PERMITUMIT I YEAR ORK IS STARTED WITHIN I.DAYS
PROVIDED
Engr. Inspection
ATION
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'4PPLICA ON BEHALF 01 HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCFSORS
Fire Review
PlanChk.Deposit
1. INTEREST, AGREES TO INDEIIINIFY� O11EIID AND HOLD HARMLESS THE CITY OF
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Ell WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt#
B,-ECTLY OR INDIRECTLY
ALL CLAIMS FOR DAMAGES HATEVER NATURE. An SING DIRECTLY OR INDIRECTLY
OFW PE .MIT HALL N T BE
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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9 DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE
N . VISION
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY FDHA C _ Pa.
Recording Fee
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Receipt #
HA I
I HEREVY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, A D THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
N �
ThIsapplicaso " '`I,I,n,1b"'
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
PERSON WILL BE EMPLOYED
CALL
BOdI.I; OMOW t,1�hI`/hZ,t F.r_. Nd*.
IN DOING TH FIX AU D RaEG%N
TION; AND E Wo BE ON RELATING TO
IN VIOLATION OF THE LABOR 0
TH�I'Z`E.ETSTATE F0.AR.INGT
FOR INSPECTION
WORMERS CO N NSURA E AND NOW 18.27.
W,NSATIO I
DATE
ER RA T) — DATE SIGNED
(425)
�j�SIGNATURE
IIAL
I
,
771-0220
ATTENTION'
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-
ORIGINAL -FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PtNK-OWNER GOLD�ASSESSOR
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Gas Test ............
Gas Piping .................
Equipment .................
Commercial Final
EXTER OR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...............
Floor Insulation
Wall Insulation ..........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION