20040009.pdfW
DATE RECEIVED
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USE PERMIT
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CITY OF EDMONDS NUMBER CX
JOB "P SUITE/APT#
CONSTRUCTION PERMIT APPLICATION ADDRESS -C
VNER NAME/NAME OF BUSINESS
IL C �� Z, 1 0 PLAT NAME/SUBDIVISION NO LOT NO LID NO.
LM MAILING ADDRESS LID FEE
u d 13
0 7 ESCP AP 1�10vc
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Rw Pornilt Required 13
10: log q 64 P Street Use PormIt 1`100 13
CITY EXISTING — PROPOSED Inspectirin Required 0
ZIP T�L��PHONE Sidewalk Required E3
4 ? Underground
-a 7 RFQUIRF0 DEDICATION— IFT wiring requited C1
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NAME METER SIZE_ LINE SIZi PRV REQUIRED
YES NO ZE
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EXPIR�l ION PATE 9CKED Do ry PO TED
STATE LICENSE NUMBER U
cy, I unheatep spacm �APM17016s
S A REVIEW
PROPERTY TAX ACCOUNT PARCEL NO. COMPL ml 1 AtT�EF PROPOSED ALLOWED PROPOSED
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LOT COVERAM R !ACKS (Fr.) PROPOSED SETBACKS (FT.)
NEW RESIDENTIAL PLUMBING I MECH . I . N r fiml. WT UR SIDE REAR 0
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COMPLIANCE OR
ADDITION COMMERCIAL z
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PARK114G jrLjNr1Nd NEW04614kU 11 DATE 5
REMODEL MULTIFAMILY SIGN ROVII M SHALL NOT 91.
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GRADING FENCE or 111i'llf%r-
REPAIR CYDS ( X FT) REMARKS k1uliffTED
OTHER
E3 DEMOLISH TANK F1
Z Ei GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
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(TYPE OF USE, BUSINESS OR ACTIV EXPLAIN: CHECKED BY TYPE OF CONS Ru CPE OCCUPANT
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NUMBER RITICAL ni
NUMBER OF C OCCUPANT
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OF DWELLING AREAS SPECIAL INSPECTION AIREA LOAD
M UNITS REQUIRED S
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DESCRIBE WORK TO BE DONE
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PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
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VALUATION
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Description FEE Description FEE
Plan Check State Surcharge
HEAT SPURCE GLAZING % LOT SLOPE % Building Permit City Surcharge
C-7 et —) I
PLAN CHECK NO: VESTED DATE Plumbing Base Fee
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical
t- BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
i DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
:3 SEPARATE PERMISSION.
Engr. Review
cc PERMIT APPLICATION: 180DAYS
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PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
Iu IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIREC FLY OR INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF I [its PERMIT SHALL NOT BE
0 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due
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O NOR LIMIT IN ANY WAY THE CITYS ABIL11Y TO ENFORCE ANY ORDINANCE PROVISION.*
Recording Fee Receipt # 73Y
I 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/tier Deputy: and Fees are paid. and
IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION fecicipt is acknowledged in space provided.
WORKMEN'S COMPEN��RTFIANCE AND RCW 18 27.
F,�IMLS SIGNAr LIF DAT
SIGN RE (OW R AGE DATE PIGNED/ (425) 't
20 n T[
N ASED BY D TE
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771-02
_77 7j
'A'iiiNTION 1/1 7 -70 3 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 PINK - OWNER GOLD - ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
'FOUNDATION:
Footirib".: .............
Pier/Porch .................
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Retaining Wall ........... 0
Slab Insulation .......... 0
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PLUMBING:
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Undergroun d ........
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3:
M
Rough -in ................... C
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0
Comm erc6l"Final ...... 0
0
—4
HEATING: M M
M Z
GasTest ....................
C
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING M M
NAILING.......................... 0
0
FRAMING........................ M
9 Cn
FIRST FLOOR FRAMING ... M 0
Z
INSULATION ...................
Floor Insulation .........
3:
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Wall Insulation ........... z
3:
Ceiling Insulation .......
cn
SHEETROCK NAILING ... z
0
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SPECIAL INSPECTION ... 3
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .................. i
900
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