20040262.pdfDATE RECEIVED
C1W OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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OTHER
FIRE SPRINKLER
FIRE ALARM
NUMBER NUMBER OF CRITICAL
OF DWELLING AREAS
STORIES UNITS NUMBER
DESCRIBE WORK TO BE DONE
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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ENGINEERING REVIEWED BY
FIRE REVIEWED BY
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SEPA REVIEW
COMPLETE EXEMPT
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LOT COVERAGE
ALLOWED PROPOSED
I ESCII Approved
RW Permit partrirod
Street Usa permit Hoq'd
Inspection Required
Swinwalk Hortuired
Underground
Wiring required
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FRONT SIDE REAR FRONT LJR SIDE REAR
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r4i C) i4ed Description
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HEAT SOURIC GLAZING LOT S1 OPE % Building Permit
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PI AN ChECK NO: VESTED DATE Plumbing
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 (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
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PERMIT APPLICATION: IGODAYS
91.
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN IGO DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
"APPLICANI ON BEHALF OF FITS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review
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j IN INTEREST, AGREES 10 INDEMNIFY, DEFEND AND IJOLD HARMLFSS 17HE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGEN IS FHOM ANY AND Fire Inspection
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ALL CLAIMS FOR DAMAGES OFwHArEVFR NATURE, ARISING DIRECTIY OR INDIRFCIIY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PFRMIT SHALL NO r BE
Landscape Insp.
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DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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NOII LIMIT IN ANY WAY THE CITY'S ABILI1Y 10 ENFORCE ANY ORDINANCE PROVISION"
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I Recording Fee
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLicArION; IIIAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTiIORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL
TION; AND IN DOING THE WORK AUTHORIZED NIEREBY, NO PERSON WIIL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF TIIE STATE OF WASHINGTON RELATING TO FOR INSPECTION
WORKMEN'S COMPENSATION INSURANCE AND IICW 11127
SIGNAT (425)
,OE (OWNER GEttl DATE Si NED
/M LL -1 771-0220
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A TENTION (11 EX 1 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FEE Description
State Surcharge
City Surcharge_
Base Fee
FEE
Plan Chk. Deposit
Receipt #
Total Amt. Due
Receipt I 3;rl
APPLICATION APPROVAL
his application is flol it Permit until signed by tile
BUilding 011icial or titsitici Deputy: and Fees ate paid. and
ieceirit is acknowledged in space provided. j
P'RICIA1,S)SIGNATUR171 p (/ATE
09,,03 PRESS HARD -YOU ARE MAKING 4 COPIES
1) BY I " DAT
ORIGINAL FILE YELLOW- INSPECTOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ......
HEATING:
Gas Test ....................
Gas Piping .................
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
OCCUPANCY ..................
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