20050130.pdfDATE RECE ED 7
PERMIT EXPIRES
PERMIT
CITY OF EDMONDS NUMBER_ CT e ,5 Z
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APTN
OWNER NAME/NAME Or BUSINESS
PLAT NAME]SUBDIVISION NO, LOT NO, LID NO,
VAILINGADDRESS cL LIE) FEE S
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I I I q Z RW Permit Required [3
0 71n PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
Street Use Permit Required 13
CITY ZIP TELEPHONE EXISTING PROPOSED Insijection Required 13
Sidewalk Required [3
REQUIRED DEDICATION FT Undurgiound 13
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NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
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L) OWNERiCONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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STATE LICENSE NUMBER EXPT/T Or DATE CHECKED VARIANCE OR CU SHORELINE OR ADB# INSPECTION SEPA
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j PROPERTY TAX ACCOUNT PARCEL NO. CAN ZONE SIGN AREA HEIGHT
4 WAIVER 13 ALLOWED , PROPOSED ALLOWED , PROPOSED
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NEW RESIDENTIAL PLUMBING I MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
& 4 ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR
ADDITION COMMERCIAL COMPLIANCE OR . z
El CHANGE OF USE
MIXED USE
PARKIN�� LOTAREA PLANNING REVIEWED BY DATE
R EMODEL MULTIFAMILY SIGN REO'D PR Q.
REPAIR GRADING FENCE
CYDS X FT.) REMARKS
DEMOLISH TANK OTHER
GARAGE o RETAINING WALL FIRE SPRINKLER
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�E (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
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DESCRIBI VOR OBE40NE
REMARKS
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BY: 'n vent connectors required
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BY: on UeV�burning appliances passing
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Description FEE Description FEE
441) VESTED DATE. Plan Check State Surcharge
HEATNURJ�Er LOT SLOPET 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)
uld
IL PERMIT LIMIT: SEE ECDC 19.00.005(A)(6) Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
&APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit
Ui
_j IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due
0 NOR LIMIT IN ANY WAY THE CITY's ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
x Recording Fee Receipt #
1 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 hisimir Deputy! and Fees are paid. and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
N
0 receipt is acliInowledged in space provided
LINVIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION I
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27. /E
FF i�LS SIGN IE D7E
SSIGNAT DATE SIGNED
70E (OWN (425)
771-0220 REL EAS'Eb By of
ATTENTION EXT. 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL __j
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL FILE YELLOW - INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 If 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 ..........................
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Pier/Porch .................
Retaining Wall ...........
7, rn
Slab Insulation ..........
— -4
Cft
PLUMBING:
M
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M
Underground ..............
0
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-Flough-in ...................
M
M Z
Commercial Final, ......
10-4
HEATING:
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Test
Gas ....................
0)
Gas Piping .................
Equipment .................
M M
0 co
Commercial Final .....
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0 M
EXTERIOR SHEATHING
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NAILING .... ........
..............
M 0
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FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ......... ........
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Floor Insulation .........
Wall Insulation ... .........
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Ceiling Insulation .......
0
SHEETROQK NAILING
M
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................