20050188.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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ADDRESS
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PERMIT EXPIRES
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LOT NO
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LID FEE S
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METER SIZE
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REMARKS
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PROPER cou T P3AELf4O
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LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
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COMMERCIAL COMPLIANCE OR z
ADDITION z
MIXED USE F� CHANGE OF USE I - z
PARKING LOTAREA PLANNING REVIEWED BY DATE 5
REMODEL MULTIFAMILY SIGN REO'D PROVIDED
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OTHER
DEMOLISH TANK <Vr-
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CARPORT ROCKERY FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
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2-1 REMARKS
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GEOTECH REPORT
BY:
STRUCTURAL DESIGN
BY:
VALUATION
Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE LOT SLOPE% VESTED DATE
Building Permit City Surcharge As
CK NO: Plumbing q Base Fee 30
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t- 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)
W
IL PERMIT LIMIT: SEE ECDC 19.00.005(A)(6) Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
V) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit
in
W 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
:E FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
D TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Anil. Due
DEEME
% 0 Y WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
NOR LIMIT IN AN
--- 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 This application is not a parmit until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building C)Hiclal or hslher Deputy, and Fees are paid, and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED receipt is acknowledged in space provided
IN VIOLATION OF THE LAaDR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
7 E E MPLOY ED
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RE ATIN
WORKMEN'S C InRANCE AND RCW 18:27. !Gj off JCIALSSIGNI)TURE DATE
SIGNATURE (OWNER AG NT DATE SIGNED (425)
7 -0220 LYr B.
71 REL SED 4 DATE
-ATTENT 11 ION EXT. 1333 L/I fill, /P Icy- 7
IT IS UNLAWFUL TO USE OR OCCUPYA BUILDING OR STRUCTURE UNTIL 1, W,
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL - ILE YELLOW INS/ECTCR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC110. PINK - OW GOLD -ASSESSOR
10/04 PRESS HARD - YOU ARE MAKING 4 COPIES
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
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0
Retaining Wall ...........
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0
Slab Insulation ..........
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PLUMBING:
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Underground .............
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Rough -in ...................
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0
0
Commercial Final ......
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HEATING:
M
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Gas Test ....................
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Gas Piping .................
3:
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Equipment .................
0 -n
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Commercial Final .......
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M M
EXTERIOR SHEATHING
0-0)
NAILING ..........................
0 r-
0 M
FRAMING ........................
C:
Q 0
FIRST FLOOR FRAMING...
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INSULATION ...................
Floor Insulation .........
3:
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Wall Insulation ...........
Ceiling Insulation .......
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SHEETROCK NAILING ...
0
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SPECIAL INSPECTION ...
IT!
MISCELLANEOUS ..........
FINAL APPROVAL FOR
3
OCCUPANCY ..................
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