20050133.pdfDATE RECEIVED , / - - �Iz_ I `
IRES
PERMIT EXP
PERMIT
CITY OF EDMONDS NUMBER
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
ADDRESS/00,<— 5-7111�,,l 4-2-02-6
OWNER NAMEIN ME OF BUSIN SS
(-' (, $1 PLAT NAMEISUBDIVISION NO. LOT NO, LID NO.
MAILING ADDRESS LID FEE S
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0-2,49 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required 13
0 Street Use Permit Required 13
TELEPHONE EXISTING _ PROPOSED inspection Required [3
Sidewalk Required [3
REQUIRED DEDICATION FT underground [3
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NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
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PROPERTY TAX ACCOUNT PARCEL NO.
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LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.)
11 NEW RESIDENTIAL PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
13 COMMERCIAL COMPLIANCE OR z
1:1 ADDITION
1:1 MIXED USE CHANGE OF USE
PARKING LOTAREA PLANNING REVIEWED BY DATE
13 REMODEL 1:1 MULTIFAMILY SIGN REQ'D I PROVIDED
GRADING FENCE
REPAIR 11 CYDS ( x FT.) REMARKS
DEMOLISH 1:1 TANK El OTHER
EGARAGE RETAINING WALL FIRE SPRINKLER
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Description FEE Description FEE
Plan Check State Surcharge
LOT SLOP ESTED DATE Building Permit City Surcharge
HEAT SOURCE E% T 7 il
PLAN CHECK NO: Plumbing Base Fee
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical
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 ig.00.005(A)(6) El Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Fire Review Plan Chk. Deposit
(n 'APPLIC�NT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
LU 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 LandscapeInsp. Total Amt. blue
01 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 7'PPLICATION 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 acknowledged in space provided
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is
WORKMEN'S COM PENSAqll RANCE AND RCW 18:27. F ALS SIG I N TURE DATE
RE (OWN Ro AGENT): DATE7GNED (425)
771-0220 -TE ErEMM_ DATE
NTION 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. UBC109 / IBC110 / IRC110. PINK -OWNER GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wall ......
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Slab Insulation ..........
0
PLUMBING:
Underground .........
Rough -In ................... .
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Commercial Final . ......
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HEATING:
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Gas Test ....................
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Gas Piping ..................
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Equipment ..... ............
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Commercial Final .......
EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING! ........................
0 ITI
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FIRST FLOOR FRAMING...
ITI 0
INSULATION ........ ...........
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Floor Insulation . .........
3:
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Wall Insulation ...........
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Ceiling Insulation .......
SHEETROCK NAILING
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SPECIAL INSPECTION ...
0
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MISCELLANEOUS ......
FINAL APPROVAL FOR
OCCUPANCY