20040063.pdf0
DATE RECEIVED/
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEMAME OF BUSJNESS
ING ADDRESS
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NAME
06111:1*11-1
CITY
ADDRESS
STATE
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PROPE
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NUMBER
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COMMERCIAL
MULTIFAMILY
GRADING CYDS
TANK
RETAINING WALL
F30CKERY
,OR ACTIVITY) EXPLAIN:
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DWELLING
UNITS
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DESCRIBE WORK TO BE DONE
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PERMIT EXPIRES
USE PERMIT
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REMARKS
OWNERIO
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I ENGINEERING REVIEWED BY
XPLUMBING
/ MECH
COMPLIANCE OR
USE
CHANGE OF
SIGN
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FIRE SPRINKLER
FIRE ALARM
CRITICAL
AREAS
NUMBER
LOT SLOPE %
VESTED DATE
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DATE
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VARIANCE OR CU SHORELINE ORAD111 I INSPECTION BOND
REO'D POSTED
SEPA REVIEW SIGN AREA DYES ONO Is HEIGHT POSED
COMPLETE I EXEMPT ALLOWED , PROPOSED ALLOWED PRO
EXP
LOT COVERAGE REQUIRE; SETBACKS (FT) PROPOSED SET13ACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
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PARKING LOT AREA I PLANNING REVIEWED BY DATE
REO'D I PROVIDE
REMARKS
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REQUIRED [] YES
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PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D F5
VALUATION
Description
Plan Check
Building Permit
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
cc PERMIT APPLICATION: 11110DAYS
Ld
PERL41T LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
FEE Description
State Surcharge
City Surcharge
0' Base Fee
FEE
'APPI ICAN 1. ON BEHAt F OF kits OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTERESI, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
FDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt
2
cc
At I Ct AIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
x
x
FROM I HE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapeinsp.
Total Amt Due
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I)FF.MED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
I WIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
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NOR
Recording Fee
Receipt
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; TIIAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
I AGREE 10 COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
-This application is not a permit until signed by the
THE OWNER
110N. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
RELATING TO
FOR INSPECTION
Building Official or his/her Deputy: and Fees are paid, and
receipt is acknowledged in space provided.
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
WORKMEN'S COMPENSATiONIRS—U0ANCE AND RCW IB.27.
0 FIC -S SIGNAT E D
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DATE D
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771-0220(
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LEASED BY
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
PINK - OWNER GOLD - ASSESSOR
09�03 PRESS HARD -YOU ARE MAKING 4 COPIES
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-,,,.,,..RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
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FOUNDATIO.N�%"':'
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Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final ......
HEATING:
Gas Test ....................
Gas Piping ................. MIS _dA
Equipment.................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING ...
INSULATION ...................
Floor Insulation .........
Wall, Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR Q _kA
OCCUPANCY ..................
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