20050498.pdfI 7PERMIT EXPIRES
DATE RECEIVED
'PERMIT ()qc-
CITY OF EDMONDS NUMBER Q,
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CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
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OWNER "E/NAME OF B SINESS Z2 :a
PLAT NAME/SUBDIVISION NO. LOT No LID NO�
MAILING ADDRESS LID FEE S
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Aripfavea E3
0 R1,V Permit Required '3
C Street Use Permit Required E3
ZIP EPHONE EXISTING PROPOSED Inspection Required 0
",4� Sidu*alk Roquited E3
13 REQUIRED DEDICATION FT Underground E3
TEL
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Wiring (equiled 13
NAFAL METER SIZE LINE SIZE NO, OF FIXTURES PRV REQUIRED
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I= ADDRESS REMARKS LU
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1:1 NEW 9L RESIDENTIAL PLUMBING MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
0 ADDITION COMMERCIAL COMPLIANCE OR z
CHANGE OF USE E
MIXED USE z
PARKING LOT AREA PLANNING REVIEWED BY DATE 15
1:1 REMODEL MULTIFAMILY SIGN REQ'D I PROVIDED 06
GRADING FENCE
11 REPAIR 1:1 CYDS El ( X FT.) REMARKS
1:1 DEMOLISH. TANK El OTHER
z 1:1GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTIVITY) EXIPLAIN:
TIBE.99-eONSTRWIC.TION C070 J07CUPANT
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OF DWELLING SPECIAL INSPECTION CONSULTANT OCCUPANT
0 STORIES UNITS LOAD
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REMARKS
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GEOTECH REPORT
BY:
STRUCTURAL DESIGN
BY:
q/r a5aYA �2,s VALUATION
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Description FEE Description FEE
Plan Check State Surcharge
.HEAT SOURCE LOT SLOPE% ESTED DATE
Building Permit City Surcharge
rLAN CHECK NO: Plumbing Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PER MIT 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)
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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
In � .11�
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_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 LandscapeInsp. Total Amt. Due
71 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- _,Sz) j
Recording Fee Receipt # 12 It
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT; AND TH rH WNER, OR THE DULY AUTHORIZED AGENT OF This application is not a permit until signed by the
AT I AM T
THE OWNER. I AGREE TO COMPLY WITH"?TY AND STATE LAWS REGULATING CONSTRUC_ CALL Building Official or his/her Deputy and Foes are paid. and
TION; AND IN DOING THE WORK AU7 ID �EREBY, NO PERSON WILL BE EMPLOYED
I OR Z4E
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IN VIOLATION OF THE LA OF STATE OF WASHINGTON RELATING TO FOR INSPECTION T�l receipt is acknowledged in space provided
WORKMEN ls5j�ONSARIN NICE D RcW 18:27.
st N R ATE �1137 (425 11 1 1� -IALV'S11 RE
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771 w0220 'RELEAS DATE
AtTiElfbW EXT. 1333 )_Y
IT IS I INLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL L
A FINAL INSPECTION HAS BEEN MADE AND APPIRUVAL IJK A GER11- ORIGINAL - FILE YELLOW - INSPECTOF
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBCiO9 / IBC110 if IRC110. PINK -OWNER GOLD ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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FINAL PROJECT APPROVAL FORM
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FIRE DEPARTMENT DAT
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PLEASESIGN
ENGINEERING DIVISION DATE
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PLANNING DIVISION DATE
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PLEASUSIGN
PROJECT 444-C,
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PERMIT# 9-005 ADB# DATEINSPECTED
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DESCRITTION OF WORK TO BE INSPECTED 62^6��_
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'A field inspection was conducted to determine compliance with -approved plans. Final: approval
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denotes that there are no objections fr m the above signed Departme t
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
El Copy of CORRECTION NOTICE given to owner/contractor by inpector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
�Date Signature
1:tenip:b1dg:fomis:oca1)rv1 3/25/04
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
Wall.............................
Pier/Porch .................
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Retaining Wall ............
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Slab Insulation ..........
PLUMBING:
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Underground .............
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Rough -in ......... .........
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Commercial Final ......
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HEATING:
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Gas Test ..................
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Piping .................
Equipment .................
Commercial Final .......
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EXTERIOR SHEATHING
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NAILING ...................... I
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FRAMING ........................
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FIRST FLOOR FRAMING....
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INSULATION ...................
Floor Insulation ..........
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Wall Insulation ...........
Ceillng Insulation .......
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SHEETROCK NAILING
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SPECIAL INSPECTION.
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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OCCUPANCY ..................
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