20040086.pdfDATE RECEIVED ze PERMIT E PIRES
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USF PERMIT _A0
CITY OF EDMONDS ZONE NUMBER
JOB SUITEIAPT#
CONSTRUCTION PERMIT APPLICATION ADDRESS_
OWNER NAMEINAME OF BUSINESS
PLAT NAME/SUBDIVISION NO LOT NO LID NO
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Cr[MAILING All It SCV Approved 13
I CIAL STREET MAP Roquired [3
z PUBLIC RIGHT OF WAY PER OFFI lialit tjsiy, arlil Florid 13
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MET -R 13
NAME NO 13
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ADDRESS CONIROL/DRAINAGE
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77 14 V U105 SEPA REVIEW SIGN AREA HEIGHT
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PROPERTY TAX ACCOUNT PARCEL NO. \1_1l COMPLETE EXE
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ADDITION OMMERCIAL ITMC 81 - z
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A AREA PLANNING REVIEWED BY 11.
REMODEL 11 MULTIFAMILY 1:3 SIGN RE D PROVIDED
REPAIR 1:3 GRADING CYDS 13 FENCE x Fr) REMARKS
OTHER
M DEMOLISH 11 TANK 11
GARAGE RETAINING WALL FIRE SPRINKLER
z CARPORT 1:1 ROCKERY FIRE ALARM
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(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CHECKED BY TYPE OF CONSTRUCTION CODE OCCLJIPANTI_�
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U) M B R NUMBER OF
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3 0 DWELLING AREAS SPECIAL INSPECTION AREA LOAD
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c e PROGRESS INSPECTIONS PER li 108/FINAL INSPECTION REQ'D
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Description FEE Description FEE
Plan Check state Surcharge
HEAT SOURCE GLAZING % LOT SLOPE % City Surcharge
Building Permit 6
PLAN CHECK NO: VESTED DATE Plumbing Base Fee
I_ Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
M SEPARATE PERMISSION.
I Engr. Review
IM PERMIT APPLICATION: 180 DAYS
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CL PERMIT LIMIT". I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engl Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
I HS Fire Review Plan Chk. Deposit
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESO
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 P
cc IRECIIY OR INDIRFC[ty
4 ALI. CLAIMS FOR DAMAGES OF WHATEVER NAT URE, ARISING D
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF I HIS PERMIT SHAI. I NOT BE ape Insp. Total Amt. Due
AIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landsc 2
DEEMED TO MODIFY, W RDINANCE PROVISION
0 NOR LIMIT IN ANY WAY THE CITY'S ABII_I1Y TO ENFORCE ANY 0
Recording Fee
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, Oil THE DULY AUTHORIZED AGENT OF I tits application is riot a permit until signed by the
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL Building 011icial or his/her DOPUl and Fees ate, paid, and
TION. AND IN DOING TIIE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
RELATING TO FOR INSPECTION receipt it; acknowledged in space provided
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON .111 D:,T E
WORKMEN'S COMPENSAl ION INSURANCE AND RCW 16 27 OFFICIAL �"S 9NAT
DATE SIGNED
(OW ER GE (425)
SIGNATUR
771-0220 BEL 'EASE[) BY DATI!
ION EXT 1333
IT IS UNLAWFUL. TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL Oil A CERTIFI- ()IiIGINAL FILE YELLOW- INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK 01,AJNEII GOLD - ASSESSOR
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RECOIJD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch ................. z
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Retaining Wall ...........
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Slab Insulation ..........
PLUMBING:
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Gas Test .................... >
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EXTERIOR SHEATHING
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FRAMING ........................ Cn
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Wall Insulation ...........
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SHEETROCK NAILING ... --I
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
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