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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME, NAME OF BUSINESS
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MAILING ADDRESS
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NAME
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ADDRESS
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NAME
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2 CITY ZIP TELEPHONE NUMBER
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STATE LICENSE NUMB ER EXPIRATION DATE
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Legal Description of Propejk&:� �Cde all e6sem6nts
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Property I
Tax Account 0 Ll (4 L/ (0�
Parcel No.
EINEW OFIESIDENTIAL 20'PLUMBING
ADDITION COMM . EFICIAL 200�MECHANICAL
REMODEL A5.1 . BILD . G. SIGN
FENCE
REPAIR CYDS._ x _FT)
7 DE ILISH WOODSTOVE SWIM POOL
MANSERT HOT TLIB/SPA
ARAGE RETAINING WALL/
El POCKERY
RENEWAL
[TYPE OF USE. BUSINESS OR ACTIVITY) EXPL�IN:
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BER NUMBER. OF CRITICAL
OF DWELLING AREAS
STORIES I UNITS INUMBER(JOOL(t
FESCRIBE WORK Tqj BE DONE (ATTACH PLOT PLAN)
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ZONE 0 PERMIT
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JUD SUITE!APT u
ADDRESS okive- co.
.EGAL DESCRIPTION CHEUKI SUBDIVISION NO —I LID NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
EXISTING —REQUIRED DEDICATION
AIN Permit Required
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Street Use Permit Req d
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PROPOSED
Inspection Required
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Sidewalk Required
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REMARKS
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SIGN AREA SEPA REVIEW 11111N111111111 ADB NO
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EQUIRED 13 YES GROUP LOAD
;PROGRESS INSPECTIONS PER . UBC 30S
NAL INSPECTION REQUIRED
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HEATtbURCE: GLAZING
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Plan Check No. 0_�
PLAN CHECK FEE
13UILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY,
GRADINGIFILL
Any construction on the public domain (curbs, sidewplks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I Your - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
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successors In interest, agrees to Indemnify, defend and hold
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harmless the City of Edmonds, Washington, Its officials,
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employees, and agents from any and all claims for damages of
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whatever nature. arising directly or Indirectly from the Issuance
of this permit, Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
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nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and In doing the work authoriz.
AUTHORIZES
ed thereby, no person will be employed In violation of the Labor
ONLY THE
Code o the a of Washington relating to Workmen's Compensa.
WORK NOTED
tion. - ur nce.
INSPECTION
SIGNATURE WIN R AGENT) DATE SIGNED
DEPARTMENT
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CITY OF
EDMONDS
ATTENTION
CALL FOR
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
771-0220
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
3.3_�
CHAPTER 3.
111
10247
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APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his/her
Deputy: and fees are paid, and receipt Is
acknowledged in space provided.
IC TURE DATE
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ORIGINAL File YELLOW Z Inspector
PINK — Owner GOLD — Assessor /6
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APPROV�WAKS NOTED
BY ENG(NEERING
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fl� - APPROVED BY PLANNIN& -% �
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Height Calculation Worksheet
Address:
Date:
Inspector(s):
1. Datum Point:
2. Datum Point Elevation:
3. Average Grade:
4. Maximum Elevation A.Uowed: Iola (average gradde) + 25
5. Reference Point Elevation Shot to House: .
911��`::�(ddatum elevation) (grade to transit.level line shot to house)
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6. Measurements from line shot onto ho to roo
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Total
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7. Actual Elevation:3 0 (reference point elevation) (measurements
from ff 6) 35 0 .f
Conclusion:
(allow - therefore the house is/
(actual) is greater Jqe:s7i-s�than �I CU)
Is not over the height requiremenfpwECDC 16.20.30 requirements
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PLUMBING:
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HEATING:
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SHEETROCK NAILING . . .
IALJ"SPECTION . . .
to
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FINAL APPROVAL;
FOR OCCUPANCY . . . . . . .
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CITY OF EDMONDS 12b. NE PERMIT
NUMBER
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CONSTRUCTION PERMIT APPLICATIOW. JOB SUITE/APT to
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OWNER NAME �'NAME OF BUSINESS I
< -- _- I � ITAI DESCRIPTION CHECK SUBDIVISION NO LID NO
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TESCP Approved 13
0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP [3
CITY Lit, TELEPHONE NUMBER RW Permit Required
EXISTING — PEOUIRED DEDICATION Street Use Permit Req-d 13'
Inspection Required C3
PROPOSED Sidewalk Required 13 a
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SIGN AREA SEPAREVIEW ADB NO. 0
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STRY
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REPAIR
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INSERT REOUIRED ICY
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RETAINING WAL
ARAGE L/ RENEWAL Fn
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PROGRESS INSPECTIONS PER UBC 305
(TYPE OF INESS OR ACTIVITY)
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2 UMbER OF,!j CRITICALO , (
NUMBER
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STORIES NITS
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DESCRIBE WORK T BE DONE (ATTACH PLOT PLA
VJ 1�! FINAL INSPECTION REQUIRED
FEE
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I VALUATION
tuwr — L) 4* 1 - ftIIIII
PaN bki'�K,FEE,
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BUILDING
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HEAT URCE: GLAZING -A
%
PLUMBING 0
Coco A'A'd1M i
M
MECHANICAL
Plan.Check Nos
Y. GRADINGIFILL
This Permit covers work to be done oh private, property ONL
Any construction on the public domain (curbs, sidewalks, E/-j
a' uees, etc.) will require separate permission. STATE SURCHARG
driveways..m rq T�t
permit Application: 180 Days STORM DRAINAGE 4&Y
Pirmit Limit: I Year - Provided Wqrk Is Started Within 180 Days and . ENO. I INSPECTION FEE
N ..Applicant; on behalf of his or her spouse, heirs, assigns
su ccessorsjn interest, agrees to IndemnIfy, defend and hold
harmless ��.he City of Edmonds, Washington, its officials,
nts from any and all claims for damages of
5 employeesi and age y,or Indirectly from the Issuance
5 whateyer natu0b. arising direct(,
of this permit. Issuanbe-of this1permill shall not be deemed to PLAN CHECK DEPOSIT
1.0j
modify,' waive or reduce any re4ulrement of any City ordinance
y ordinance TOTAL AMOUNT DUE
nor limit in any way the City's ability'to enforce an
provision." I -
I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL
Uly
Information given is correct; and that I am the owner, or the d " 11VI 1`1
h city, and TI 14ql I�IE 't s not a permit until
.gn Thi
1)qz- 'A 6 4,.�-,,signecl by the Building Official or his/her
authorized agent of the owner. I agre6 to comply with I; A LIT a application I
state laws regulating construction; and In doing the 1vork-Eildth
ed thereby, no ers n will be employed In violatio"A of tKeLibql; N LV. 'THE,'
p WORK'NOVE6" beputy; and fees are paid, and receipt is
a 0
�e ashington relating to Workmen's Compensa
Code of ths§!� INSPECTION acknowledged In space provided.
Its 111�
insur - -F -
SIGNATURE VqN 0 AG N UA It alu"Cki DEPARTMENT OFFICIAL S SIGNATURE DATE
CITY OF
4?
or EDMONDS
LEAS D E
CALLIFOR j yl -2
ATTENTION INSPECTION
IT IS UNLAWFUL TO USg.OR OCCUPY A BUILDING OR STRUCTURE I Z Inspector
X� UNTIL A FINAL INSPECTION HAS bEEN MADE AND APPROVAL OR 771-0220 ORIGINAL -�'File YEL. LOIA
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.
uBc NII< — owner GOLD — Assessor
CHAPTER 3. '13�
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