20050743.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PERMIT
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PRY REQUIRED
YES 0 NO
REMARKS
OWNEWCONTRACTOR RESPONSIBLE FOR EROSION COHTROUDRAINAGE
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ENGINEERING REVIEWED BY DATE
LV_ -7
FIRE REVIEWED BY DATE
CITY ZIP TELETHON
STATE LICENSE NUMBER EIPI'TIIN
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FEE
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VESTED DATE
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City Surcharge
PLAN CHECK NO: 05- ZM
Plumbing
Pu_b'BC'
lInspection
Base Fee
THIS PERM T AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS _ORKT
.MIT COVE S W RK To
"Bech-mc.,
Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUC TION ON THE PUBIC
CT.O. ON THE PUBIC
DONMAIN (CURBS. SIDEWALKS. D WAY% MARQUEES, ETC.� WILL REQUIRE
RIVE OU
Grading
SEPARATE PERMISSION.
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PERMITAPP CATION: SEE ECDC 19.06,005(A)(5)
Engr. Review
Engn l
PERMIT LIMIT. SEE ECOC 19.00.005(A)16)
SEE BACK OF PINK PERMIT FOR MORE INFO]
RMATION
PLICANT, ON BEHALF 01 HIS OR HER SPOUSE, HIMS, ASSIGNS AND Succ,,SOR,
Fire Review
PlanChk.Deposi
IN INTEREST, AGREES TO INDEMNIF , 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
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
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
Landecapelmap,
Total Amt. Due
/-_ 11 o. a)l
Recording Fee
Receipt # D-71LW) I
IHERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR T E DULY AUTHORIZED AGENT OF
T E OWNER, I AGREE TO COMPLY WITH CIT AND STATE LAWS REGULATING CONSTRUC�
T ,,ppi.,at.,�,,,,t,p,,,,t.ni,il,gledbyth,
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
BuIclIg Oft,Ic, hev- Depety and Fall 11, Pacd. and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
1111-Pt I, Ilk—ledgese, space P,.,,dad
WORKMEN's C NCE AND RCW fll:27.
UBE DATE
DATES GNED
(425)
1-5
2-0/0 5-
771-0220
RBLEASEDBY DATE
ATTENTION
EXT. 1333
Y-6 &�
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
FICATE OF OCCUPANCY HAS BEEN GRANTED. USC1091 IBC110 I IRC110.
ORIGINAL - FILE
PINK -OWNER GOLD - ASSESSOR
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RECORD, OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ..................
FOUNDATION:
Footing......................
wall ......................
Pier/Porch ................
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Retaining Wall ...........
§Iab 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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171
GasTest ....................
Gas Piping .................
Equipment .................
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Commercial Final
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EXTERIOR SHEATHING
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NAILING ..........................
0
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FRAMING ........................
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FIRST FLOOR FRAMING..,
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INSULATION ...................
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Floor Insulation
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Wall Insulation ...........
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Ceiling Insulation
65
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SHEETROCK NAILING
SPECIAL INSPECTION
0
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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