20021011.pdfDATE RECEIVED
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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STATE LICENSE NUMBER EIPIRATION DATE
ROPERTYTAX ACCOUNT PARCEL NO.
NEW RESIDENTIAL 9 CPL -=-1M-1GD-
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ADDITION -aliarar— 0 CHANGE OF USE
REMODEL 0 MULTIFAMILY rl SIGN
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_ _CA_ RPORT ROOKERY FIRE ALARM
(TYP SINEII On ACTIVITY) EIPLAft
NUMBER aTICAL
OF NUM""
STORIES WELLINO AREAS
UNITS NUMBER 14
DESCRIlAwlitfORK TO BE DONE (Z�
PERMIT EXPIRES
USE PERMIT
ZONE NUMBER
JOB SUITEIAPT#
ADDRESS 65-0
PLAT NAMEISUSDAVISION NO.
I LOT NO.
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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MO. 01 FIXTURES
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OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONITROUDRA RAGE
FIRE REVIEWED BY DATE
VA141ANCE OR CU I 1HO111.111111AD11 I INSPECTION
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OYES ONO
LOT COVERAGE I REQUIRED SETBACKS (FT) I PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED I FRONT SIDE HEAR I FRONT 111111E BEAR
PARKING I LOT AREA I PLANNING REVIEWED BY DATE
CHECKEDBY ITYPE
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GROUP
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LOAD
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V VALUATION
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FEE
Description
FEE
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Plan Check
State Surcharge
GLAZING %
LOT SLOPE
Building Permit
City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHIORUEES ONLY THE ORKNOTED.7HIS PERMIT COVERS WORK TO
IT
HE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
T.
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MAN 1E1, ETC.) WILL REQUIRE
t: ....IFERMisstoo
Engr. Review
PE MITAPPUCATHMI: INDAYS
PERMIT UMm I YEAR - PROW ED WORK IS STARTED WITHIN ISO DAYS
Engr. Inspection
SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION
'APILICA- ON BEHALF .1 HIS .. HER SPOUSE, HEIRS, SSIGNS AND SUCCESORS
Fire Review
FlanChk.Deposft
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
IDMONDI, WASHINGTON, 'IS OFFICIALS. EMPLOYEES, AND AGINT, FROM ANY AMD
ALL CIAJMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY 08 INDIRECTLY
Fire Inspection
Receipt It
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WA
Landscapeki
Total Amt. Due
VE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Recording Fee
Receipt If
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
application asset. P.I.Rrifilaigned byther
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
,,,This
derp Official or his/her Dcpuly� and Fees are paid. and
FOR INSPECTION noopt a.0—Wet In space p—lded.
WORKMENS COMPENSATRN4_NSURANCE AND Now IS 27.
DATE
Q�.E ) DATE SIGNED
(425)
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771-0220
RELEASED BY DATE
ATTENTION
Exr 1333
T IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
On Gr,oL/pIL
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PZ,'bWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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