20050008.pdfI .
DATE RECEIVED
kCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PROPERTYTAX ACCOUNT PARCEL NO.
77 6 e9
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NEW RESIDENTIAL
ADDITION COMMERCIAL
MIXED USE
REMODEL MULTIFAMILY
REPAIR El GRADING CYOS
DEMOLISH TANK
GARAGE RETAINING WALL
CARPORT ROCKERY
(TYPE OF USE, BUSINESS OR ACTVITY)Z->.;P1rAft
EXPIRES
PERMIT --T7 .) -- —
NUMBER
JOB 4
ADDRESS (yf)
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PLAT NAME/SU;DIVISION NO,
LOT NO,
LID NO,
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LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCPApproved
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[3
RW Permit Requiod
Street Use Permi Required
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EXISTING PROPOSED
Inspection Required
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Sidewalk Required
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REQUIRED DEDICATION FT
Underground
Wiiing required
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METER SIZE
LINE SIZE
NO OF FIXTURES
PRV REQUIRED
YES 0 NOO
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REMARKS
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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ENGINEERING REVIEWED BY DATE
FIRE REVIEWED BY DATE
PRE-INSPECnON UQUIRED Lau
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STUDY 13 IS
PLUMBING if MECH
LOT COVE
ALLOWED P
COMPLIANCE OR
CHANGE OF USE
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REMARKS
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FIRE SPRINKLER
FIRE ALARM
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SEWER MUSTI PRECA
OPBM UPB SIGN AREA
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ATM MMR 70 ELE RD
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ION DATE 5
OB CARD 06
NUMBER NUMBER OF I �1�r Z "T
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OF DWELLING SPECIAL INSPECTION ULTANT PANT
UNITS :S
STORIES --I I - REQUIRED 13 :s TLOOCACDU
DESCRIBE WORK TO BE DONE
REMARKS U)
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BY:
STRUCTURAL DESIGN
BY:
VALUATION
Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE LOT SLOPE% VESTED DATE Building Permit City Surcharge
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PLAN CHECK NO: Plumbing Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION. Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEEBACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire. Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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
E Landscapelnsp. Total Amt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANC
NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APP ATION 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 his/her Deputy: and Fees are paid, and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED receipt is aclknowle�ped in space provided.
IN VIOLATIQN QE_THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
WORKMEN'tP.ONt"MSATION INSURANCE AND RCW 18:27. OFFICIA7L SIGATURE/ A E
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SIGN UR NT):: 1/00 (425)
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771.11192171
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-
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 If IBC1110 / IRC110.
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
ORIGINAL - FILE YELLOW - INSPECTOR
PINK - OWNER GOLD - ASSESSOR
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOIZ, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
L4����.ENGINEERING DIVISION DATE--il.2,e�-OS
nEME SIGN
PLANNING DIVISION DATE
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PERMIT #2&&s_—_&0jVsf_ADB# DATE INSPECTED
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DESCRIPTION OF WORK TO BE INSPECTED 07ar—
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A fleld inspection was conducted to determine final compliance with approved plans. Final approval
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denotes. that there are no objections from the above signed Department to the* release of
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PERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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0 Copy of CORRECTION NOTICE given to owner/contractor by inspector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ............
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Slab Insulation ..........
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PLUMBING:
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Underground .............
Rough -in ...................
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Commercial Final .......
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HEATING:
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Gas Test ....................
Gas Piping
...... ...........
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Equipment .................
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Commercial Final .......
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EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ....... ............
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FIRST FLOOR FRAMING....
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INSULATION ...................
Floorinsulation ..........
Wall Insulation ...........
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Ceiling Insulation .......
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SHEETROCK NAILING ...
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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