20040972.pdfDATE RECEIVED 5
TIT, 17?)= 1 PERMIT EXPIRES
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'USE PERMIT
CITY OF EDMONDS NUMBER
JOB SUITEIAPT#
CONSTRUCTION PERMIT APPLICATION ADDRESS P --JIII,., .
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O@ER NAME/NAME OF BUSINESS LID NO.
iC AA b F1_ ( J ) PLAT NAMEISUBDIVISION NO. LOT NO. LID FEE S
M MAILING ADDRESS I ESCP An �iroved
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CITY ZIP TELEPHONE 14
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F-1 NEW RESIDENTIAL 19 PLUMBING MECH ALLOWED PROPOSED FRONT SIDE BEAR FRONT URSIDE REAR
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Ei GARAGE RETAINING WALL FIRE SPRINKLER
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C�E OF USE, BUSIN SS OR ACTIVITY) EXPLAIN: CMN OCCUPANT
CHECKED BY ITYPE N )MT1014
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Ui NUMBER NUMBER OF CR ITICAL OCCUPANT
a OF DWELLING A EAS SPECIAL INSPEC N jAaEA LOAD
M NUMBER REQUIRED [j YES
01 STORIES UNITS
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PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQU
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VALUATION
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Description FEE Description FEE
Plan Check State Surcharge
HEAT SOLTRCE GLAZING % LOT SLOPE % Building Permit City Surcharge
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VESTED DATE Plumbing
PLAN CHECK NO:
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
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 160DAYS
L PERMIT LIMIMI YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Fire Review Plan Chk. Deposit
OAPPLICANI ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
IN INTERE�T. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
E EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt U
r ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
C, FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelns Total Amt. Due
3 DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE p
3 NOR LIMIT IN ANY WAY THE CI1YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION
r Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF This application is not a permit until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building Official or hisitier Deputy: and Fees are paid, and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE L/�aQR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSAPN`It�,SURANCE AND RCW 18.27. OFFICIALS, SIG NATURE r
RE (OWNER O� �GEkK (425)
e. DATE SIGNED
20 OAT
771-02 RELEASED BY'
'ATT ENTIW� EXT 1333
IT IS UNLAWFU 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
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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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 N
OCCUPANCY .................. no&_ 1
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