20040851.pdfI
PERMIT EXPIRES
DATE RECEIVED
USE PERMIT
CITY OF EDMONDS ZONE
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CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
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OWNER NAME/NAME OF BU �INESS OmIO7 =No
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0 1� 40 to f7 f-VV # (f3 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP [3
inspection floquiied [3
CITY TELEPHONE EXISTING — PROPOSED Sdewaik Required E3
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k,vpj ,O��,q IVAZ,P&)�j REQUIRED DEDICATION— Fr wiring required 13
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NO. PT ALLOWED kLLOWED PROPOSED
PROPERTY TAX ACCOUNT PARCEL COMPLETE , EXEM PROPOSED I I
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LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.)
NEW RESIDENTIAL 1:1 PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
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ADDITION COMMERCIAL 1:1 CHANGE OF USE z
PARKING LOT AREA PLANNING REVIEWED BY DATE 5
REMODEL MULTIFAMILY SIGN REO'D I PROVIDED
REPAIR GRADING FENCE
44 *;z * ryD.- I x FI) REMARKS
DEMOLISH TANK OTHER
GARAGE RETAINING WALL FIRE SPRINKLER
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(TYPE OF USE, BUSINE?,S-PR ACTIVITY) EXPLAIN:
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OF DWELLING AREAS SPECIAL INSPECTION AREA OCCUPANT
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DESCRIBE WORK TO BE DONE
REMARKS 2
PROGRESS INSPECTIONS PER UBC 108/ IBC109 IRC109 FINAL INSPECTION REO'D 2
,47/
714, Ax 5: � 1A ZK 61 &L-a—EX L2
VALUATION
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Description FEE Description
Plan Check State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge
PLAN CHECK NO* VESTED DATE Plumbing Base Fee
7) Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 Grading
M DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
I.- SEPARATE PERMISSION. Engr. Review
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Uj PERMIT APPLICATION: 100 DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE ClIFY 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 NAIURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapelnsp- Total Amt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROV00N�" i
Mi Recording Fee Rece pt #
I HER BY ACKN LEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRE ; AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF This application is not a perinit until signed by the
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THE OWNER. I AG EE TO COMPLY WITI I CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building Official of his/her Deputy: and Feesare paid, and
TION; AND IN DO] THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided-
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WORKM�N'S CO ENSATION 0 1 (A.I�s SI 'N 1URE DATE
,�NqURANCE AND RCW 18 27.
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SIGNATUR ER OR GENT) DATE SIGNED (425 t
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771-0 020 RELIfASED BY
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ATTENtrION EXT 1333
ITIS UNLAWFULTO USEOR OCCUPYABUILDING OR STRUCTURE UNTILA FINAL
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU- ORIGINAL -FILE - YELLOW- INSPECTOR
PANCY HAS BEEN GRANTED. UBC109/IBC110/iRC110. 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:
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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