20030264A.pdfDATE RECEIVEQ 7
[PERMIT EXPIRES QA
USE PERMIT
CITY OF EDMONDS ZONE NUMBER
JOB I , SUITE/APT#
CONSTRUCTION PERMIT APPLICATION ADDRESS
OWNER NAMEINAME OF BUSINESS VW LIYU/
Kii *1 � PLAT NAME/SUBDIVISION NO. LOT NO. LID NO.
MAILING ADDRESS LID FEE $
z TESCP Appro�ed
W �0
P C� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required
4- Street Use Permit Roq'd
CITY EXISTING — PROPOSED inspection Required
ZIP TELEPHONE Sidewalk Required
REQUIRED DEDICATION— FT underground
Wiring required
Ste r _Cdk
NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES13 NO 1:1 z
z
W REMARKS z
ADDRESS
OWNER/CONFRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
0
CITY ZIP TELEPHONE
NAME BL#
_Aa 62 ENGINEERING REVIEWED BY DATE
a: ADDRESS
0
U
FIRE REVIEWED BY DATE
t! CITY ZIP TELEPHONE M
0
z
VARIANCE OR CU SHORELINE OR ADBI INSPECTION BOND 0
STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY REO'D POSTED
11YES ONO S 0
SEPA REVIEW SIGN AREA HEIGHT M
COMPLETE , EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
P R
Lu EXP
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) Cl) --j
NEW t�rR ESIDENTIAL El PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR a:
z i M
COMPLIANCE OR 2 C
ADDITION COMMERCIAL CHANGE OF USE z M
PARKING LOT AREA PLANNING REVIEWED BY TE 0
0
REMODEL MULTIFAMILY REO'D I PROVIDED
Cl SIGN 0 C:
FENCE
REPAIR GRADING CYDS 1:1 X Fr) REMARKS M
I — — M Z
0 THER K) --I
DEMOLISH TANK 10, f1ri, C:
GARAGE RETAINING WALL FIRE SPRINKLER >
z CARPORT ROCKERY 11 FIRE ALARM
(TYPE OF USE, BUSINESS OR AC
OCCUPAYT-7
CHECKED BY
GROU 0 _n
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9n CRITICAL CTION AREA
LU NUMBER NUMBER OF OCCUPANT
0 OF DWELLING AREAS SPECIAL INSPE
M 6- YES LOAD
0 STORIES UNITS NUMBER REQUIRED M M
DESCRIBE WORK TO BE DONE 0
- N - REMARKS z 0
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PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REG-D FS
j Q M
C: 0)
9 Cn
M 0
Z
VALUATION X
$ —4
x
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Description FEE Description FEE z
Plan Check State Surcharge I
HEAT SOURCE GLAZING % LOT SLOPE %
I I Building Permit City Surcharge z
0
PLAN CHECK NO- VESTED DATE Plumbing
0
C - /- C-) M
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
It BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
i DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 180 DAYS
W
PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Fire Review Plan Chk. Deposit
U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIREC TLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due
_j DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION'
Recording ee Receipt 9
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in spice provided.
WORKMEN-VOUPEN'SATION INSURANCE AND RCW 18.27. OFFICIALS SIGNATURE PATE
�kNATURd,(O NEIR 0 AGEN DATE SIGNED (425)
_IG
DATE
X-1 17'1 REI[ B
771-0220
ATTENTION 7/7-7 E)ff 1333
IT IS UNLAWFUL TdUSE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL FILE Y LLOW - 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
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch ................. z
Retaining Wall ...........
M
Slab Insulation ..........
PLUMBING:
Underground ............. M
M
Rough -In ................... 0
0 C
Commercial Final ......
--I
3: rn
HEATING: M Z
Gas Test .................... (v) C
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Gas Piping .................
W
o -n
Equipment .................
--I
Commercial Final .......
M M
EXTERIOR SHEATHING 0 vi
NAILING .......................... 0 r-
0 rn
C: C/)
FRAMING ........................ Cl)
M 0
Z
FIRST FLOOR FRAMING ...
INSULATION ...................
Floor Insulation ......... >
z
Wall Insulation ...........
Ceiling Insulation .......
z
0
SHEETROCK NAILING ...
0
SPECIAL INSPECTION ... rn
MISCELLANEOUS ..........
FINAL APPROVAL FOR OQ
OCCUPANCY ..................