20050086.pdfDATE RECEIVED
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U!S F PERMIT
CITY OF EDMONDS 70NE NUMBER
'JOB SUITEIAPT#
CONSTRUCTION PERMIT APPLICATION ADDRESS Le e-� P'N
OWNER NAME/NAM OF BYSIN�ESS
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PLAT NAME/SUB jSION NO LOT NO LID NO.
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OWNER!CONTRACrOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE a
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NAME CBLN
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ADDRESS
C_ 141-1 4a"�_ C'J FIRE REVIEWED BY
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STATE LICENSE NUMBER EXPIRATION DATE CH�CKED-BY POSTED
DAVITS T
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SEPA REVIEW'
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOIA* 'MkVD I :QLLOWED , PROPOSED
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LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.)
PLUMBING1 OECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
NEW �9__REGIOENTIAt` z
COMPLIANC z
11 ADDITION Ej COMMERCIAL CHANGE OF USE z
PARKING LOT AREA PLANNING REVIEWED By DATE 5
REMODEL MULTIFAMILY SIGN ED
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REPAIR GRADING CYDS FENCE FT) REMARKS
( — X
DEMOLISH TANK Ei OTHER
EiGARAGE Ei RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTIVIT14EAPLAIN: CHECKED By IT-ITA Wjq _N OCCU NT
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NUrBER NUMBER OF CRITICAL
OF DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPANT
STORIES 57 UNIT J NUMBER REQUIRED YES LOAD
DESCRIBE WORK TO BE DONE
REMARKS z
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 63
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Description FEE Description FEE
Plan Check State Surcharge
MAT S CE GLAZING % LOT SLOPE %
C/ � Zt as I Building Permit City Surcharge
PLAN CHECK NO: VESTED DATE Plumbing Base Fee
Mechanical KI C)
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: 180DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'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 I HE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NAT URE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Total Amt. Due
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp.
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
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
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTFILIC- CALL This application is not a permit until signed by the
TION AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and
IN Vi6LATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION— receipt isacknowledged in space provided.
WORKMEN'S COMPENSA�ION INSURANCE AND RCW 18.27. DATE
OFFICIALS SIGNATURE
ENT) DATE NED
S URE (OWNE MOREN (425)
4(9 771-0220 RFI.FASED'BY DATE
Z), EXT 1 33
3
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING Oil 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-ASSESSOH
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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INSPECTOR
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch ..........
Retaining Wall ........... z
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Slab Insulation .......... +
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PLUMBING:
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Underground .............
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comm. ercial F I inal ...... --1 0
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Gas Test .................... M Z
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Gas Piping ................. z
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Equipment .................
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Commercial Final .......
EXTERIOR SHEATHING
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NAILING..........................
FRAMING ........................
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FIRST FLOOR FRAMING... C/)
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INSULATION ................... --I
Floor Insulation .........
Wall Insulation ........... >
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Ceiling Insulation ....... --I
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SHEETROCK NAILING ... z
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SPECIAL INSPECTION —4
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................