20040991.pdf11
VED [PERMIT EXPIRES
PERMIT
CITY OF EDMONDS NUMBER 7 nqci
JOB SUITEIAPT#
CONSTRUCTION PERMIT APPLICATION ADDRESS
OWNER NA EiNAME OF BUSINESS
ky' Lunn PLAT NAMEISUBDIVISION NO. LOT NO LID NO
MAILING ADDRESS LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP I ESCP ApprDvtd 13
RVV Pernin Required 0
5c),q (.3 rc� Stleal Use Permit Requited El
CITY ZIP TELEPHONE EXISTING PROPOSED ArIvqClizinpaquired [3
SOOA�ik Requirt-1 E3
r_An�mj:s REQUIRI�D DEDICATION e%
C3
METE SIV _�O 6F FIXTURES PRV AQUIRED
NAME i t�' i - 0
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ADDRESS REMARK z
OWN ERfCON-TR Av T16-R -R E-_S.P_0_N_-S�1_B_LE_ F.&R-E-R-01SION CONTROLIDRAINAG�_,
CITY ZIP TELEPHO E It,
fill 9932
NAME
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ENGINEERING REVIEWED BY DATE
ADDRESS
It'll. DATE
FIRE REVIEWED BY k- ! j
CITY ZIP TELEPHONE A S '; IT E t r. "1 8 'L
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AV VARIANCE ADB4 A _E
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STATE LICENSE NUMBER EXPIRATION DATE /'CHECK i 0 % OIAPLETED EXEMPT
_IES NO
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0) Ai"'IDN'T
CA# ZOK- 1� t�J6$l VASA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. WAIVER 13 ALLOWED I PROPOSED ALLOWED , PROPOSED
-7 D QaO�Q (c Q STUDY 13 1 1 1
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
RESIDENTIAL PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR
NEW 9
E] COMMERCIAL COMPLIANCE OR z
El ADDITION MIXED USE CHANGE OF USE I I I - z
PARKING LOTAREA PLANNING REVIEWED BY DATE 5
IL
0 REMODEL El MULTIFAMILY SIGN REQ'D I PROVIDED
R E3 GRADING E] FENCE
0 REPAI CYDS ( X FT.) REMARKS
El DEMOLISH E] TANK E] OTHER
GARAGE Ei RETAINING WALL FIRE SPRINKLER
El CARPORT ROCKERY FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTIVITY) EXP AIW TYPEf C iN
NUMBER NUMBER OF
DWELLING SPECIAL INSPECTION CONSULTANT OCCUPANT
OF UNITS LOAD
STORIES REQUIRED 0 YES
DESCRIBE WORK TO BE DONE REMARKS
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r o GEOTECH REPORT
By!
STRUCTURAL DESIGN
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r)5e+ t'n o VALUATION
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Description FEE Description FEE
il JA) Pit an Check State Surcharge
H�EHSOIJRCE LOT SIOPE"d 1.1/ VEST D DATE Building Permit City Surcharge
Base Fee
PLAN CHECK NO: Plumbing 0
THIS PERMIT AUTHORIZES ONLY TH9 WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC Grading
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6) Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Fire Review Plan Chk. Deposit
Ln *APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
Lu IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
-1
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Y CITY ORDINANCE Landscapelnsp. Total Amt. Due
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF AN
0 NOR LIMIT IN ANY WAY THE CITY's ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
x — Recording Fee Receipt # xr—) q q,
I HEREBY ACKNOWLEDGE THATIIAHMAVE RrTHIS APPLICATION; THAT THE INFORMATION APPLICATION APPRO
T TH W ER, OR THE DULY AUTHORIZED AGENT OF This application is not a permit until signed by the
GIVEN IS CORRECT; AND TW TY ATING CONSTRUC.
THE OWNER. I AGREE TO COMPLYUWIT No STAIF_�(]IUL CALL Building Official or his/her Deputy and Fees are paid, and
TION: AND IN DOING THE WORK A TH IZE T Y, NO PERSON WILL BE EMPLOYED receipt is acknowledged in space provided
IN VIOLATION OF THE LA COD OF S ATE OF WASHINGTON RELATING TO FOR INSPECTION
WORKMEN'S COrPENSA IN 18:27.
R N D RCW OFFICIJAL*SIGN TU7RE DATE
URE DATE SIGNED (425) al
SIGN k,
S By DATE
771 0220 RELEASED BY
ATTENTION EXT. 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL - FILE - YELLOW - INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC1091 IBC110 / IRC110. PINK -OWNER GOLD - ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .......................
FOUNDATION:
Footing......................
'Wall................ ; ......
PiOr/Porch ...... * ..........
.'.hetai ning Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final ......
HEATING:
GasTest ....................
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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