20040795.pdfDATE RECEIVED
[PERMIT EXPIRES
USE
CITY OF EDMONDS ZONE PERMIT
CONSTRUCTION PERMIT APPLICATION JOB NUMBER t
ADDRESS SUITE/APT#
OWNER NAME/NAME OF BUSINESS I - - -
IMI C H,4-4, I.-Y PLAT NAME/SUBDIVISION NO. LOT NO, LID NO.
uj MAILING ADDRESS
LID FEE $
TESCP Approved 0
0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP HW Permit Required 13
LATY 7FO7 P?/j-7`/ -S - c-(-- Street Use Permit Roq'd [3
ZIP TELEPHONE EXISTING — PROPOSED inspection Required [3
Sidewalk Required [3
�f 77i1P--,o2 REQUIRED DEDICATION� FT Underground
NAME Wiring required 13
METER SIZE LINE S PRV REQUIRED
LU YES 0 NO 11
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a: OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE E5
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CITY ZIP TELEPHONE Lu
NAME
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ADDRESS ENGINEERING REVIEWED BY DATE
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CITY FIRE REVIEWED BY DATE
0 ZIP TELEPHONE Ix
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VARIANCE OR CU SHORELINE 0 A DCB h� INSPECTION
STATE LICENSE NUMB ER EXPIRATION DATE Y =OND
REO'D POSTED
OYES NO S
L R60, f5b SEPA REVIEW SIGN APIE(A
2
PROPERTY TAX ACCOUNT PARCEL NO. HEIGHT
COMPLETE I EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
W
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EXP
NEW RESIDENTIAL PLUMBING MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKi (FT.)
11 1:1 ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR
ADDITION COMMERCIAL COMPLIANCE OR
CHANGE OF USE A/3 C 1,VA0 e No 0,14 -1 -;1 1?
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REMODEL MULTIFAMILY PARKING LOT AREA PMING, IiEVIE D BY DATE
SIGN RfQD F�OVIDED
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REPAIR GRADING FENCE
CYDS ( x F-T)
DEMOLISH El TANK OTHER
GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
(TYPE OF USE. BUSINE 0�1 ACTIVITY) EXPLAIN:
CHECKED BY ITYPE OF CONSTRUCTION CODE OCCUPANT
U) NU
ul NUMBER MBER OF G R 0 U P e2jL�-_- 2i
CRITICAL
OF 0 TELLING AREAS SPECIAL INSPECTION LREA OCCUPANT
'0 _STORIES U WN TS <?r
11 1 — NUMBER REQUIRED [] YES
DESCRI13E WORK TO BE DONE - -2 4 LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 108/ IBCID91 IRC109 FINAL INSPECTION REO'D z
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99AA `P340
:50 2 6064 VALUATION
_ac__ 37
Description FEE Description FEE
Plan Check State Surcharge Lf. 50
HEAT SOURCE GLAZING % LOT SLOPE % Building Permit h City Surcharge 116 1
PLAN CHECK NO: VESTED DATE Plumbing Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO U14N AIA I
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
Grading
SEPARATE PERMISSION.
Engr. Review
W PERMIT APPLICATION: 180DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection
OAPPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Plan Chk. Deposit
Fire Review
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 #
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ALL CLAIMS FOR DAMAGES OF WHATEVER NAT URE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF IHIS PERMIT SHALL NOT BE
DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Am t. Due
0
I NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee Receipt #
I 1E
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application is not a pornin until signed by the
TION; AND IN DOING TIIE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or his/her Deputy and Fees are paid, and
IN VIOLATION OF THE LABOR COD?-Oi;.,TIIE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORK��'S COMPENSATION INS NCE tND RC 18 27.
I OF qI G N AT LjF1)1, DA1 E
SIG,PKT4t (04NNE 0 EN NED C
(425)
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A/jA 7;K, 771-0220 ATI1
11 E I A T
A17EN ON E)ff 1333
IT IS UNLAWFULTO USE OR OCCUPYA BUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110. ORIGINAL. FILE YELLOW -INSPECT R
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES PINK - OWNER GOLD ASSESSOn
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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 ..................
7
The Initials MT are WWI'
T11011113son,a tc,11porary conti'act
illspector for the City-
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