20050746.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
ERNAMEIN MEOFSUSINESS
C) -I- , , , , \ I � \ ) , \ \ A , / 1!, /14- ( � v]
111E11111
ZIP
,ka I'z ... C7,"Eq
PERMIT EXPIRES
PERMIT
NUMBER
joB
ADDRESS _j_
PLAT NAMEJSUEDIVISIONI NO
LOT 10
110 NO
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED
REQUIRED B.ICATI.. _ IT
,"I na'..,
METER SIZE I
LINE S111
1 00 01 FIXTURES
PRV REQUIRED
YES 13 No 0
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRANAGE
NEW
n RESIDENTIAL
0 PLUMBING I MECH
ADDITION
13 COMMERCIAL
1
COMPLIANCE OR
0
[:] MIXED USE
CHANGE OF USE
REMODEL
a MULTIFAMILY
F1 SIGN
C�QREPAIR
0 GRADING ,ca
C] PENCE
X
rl DEMOLISH
El ToNg
ciGARAGE
CARPORT
o RETAINING WALL
ROCKERY
FIREALARIA
NUMBER OF
DWELLING
Fil "STU'oRB,�-R A- UNITS
ENGINEERING REVIEWED BY DATE I I
FIRE REVIEWED BY DATE re
_,il1EOD COMPLETED I E3r
0 YES Wool
cao, NE SIGN A 1A HEIGHT
-L-r.
WAIVER E3 P_0
STUDY 0 N I I -�� I mr
LOT COVERAGE 1 REQUIRED SETBACKS LET) I PROPOSED SETBACKS FT)
ALLOWED PRO OSED F CHIT SIDE REAR FRONT URSIDE REAR
65-/- 1 N 1131 101 IE;' N 0 C1`1 4 IF e-I!,
RE PARKING LOTAREA PI. NNING REVIEWED BY DATE
CH) PROVIDED -1 .4 411
�_ I A Ii rlf�d b t I Dq
SPECIAL INSPECTION I CONSULTANT
REQUIRED 13 YES I
0 CUPANT
GROUP I
" ��,+nj 1 -1), Lr(u-/4 *I / �Y), ' I
I � —
L4 i 1 -01 te 14 61 k?, ;Sv`j
Description
FEE
Description
FEE
I NZ 6 Z> /J_ q 12
JDATE
plan Check
State Surcharge
C)
HEAT SOURCE
1 LOT SLOPE% VESTED
Building Permit
City Surcharge
PLAN CHECK NO: z,8 q
Plumbing
Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Grading
8 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
ES DONMAIN (CURBS. SIOEWALK% DRIVEWAYS, MARQUEES. ETC,j WILL REQUIRE
SEPARATE PERMISSION.
PIERMITAPP ION: SEEECDC 19.0D.6051AIM
UCAT
Engr. Inspection
PERMIT LIMIT. SEE ECDC 19.00 005[AH6)
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 INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS' WASHINGTON� ST$ FFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt N
MSFORDAMAGE F WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
ALL CLM 0 He
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $.ALI NOT
CITY ORDINAN E
L,ndscapelnsp.
Total Amt. Due 4
DEEME D TO MODI Y� WAIVE OR REDUCE ANY REQUIREMENT OF ANY
0. NOR LIMIT IN ANY WAY THE CTY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
Receipt # z/_ V11) _L
I HEBREBYACKNOWLEDGETPIAT 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
T
THE OWNEFL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
CALL
'U'd.019 0111 ivaiell Greedy Ind FoaI am paid and
TION! AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
OF THE STATE F WASHINGTON RELATING TO
FOR INSPECTION .111pre, 1-0111d,de, sIona provided
IN VIOLATION OF THE LABOB CODE
WORKMEN'S COMPENSA^'Rh�IUMNCE AND RCW 18;27.
DATE
lip
DATE SIGNED
(425)
E
1 1-1,11411
RELEASED By DATE
ATTENTION
EXT. 1333
I_r
/t
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
- 1319,6115-
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
ORIGINAL � FILE - YELLOW - INSPE40R
FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC1091 IBC110 I IRC110,
PINK -OWNER - GOLD - ASSESSOR
i0j" PRESS HARD - YOU ARE MAKING 4 COPIES
z
0
0
C)
0
M z
>
0
-n
x
M M
a 6;
0 r-
0 ITT
C (j)
9 V)
M
Z
7-1
z
-4
x
0)
z
0
M
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS............ ..........
FOUNDATION:
Footing ......................
Wall ..............
Pier/Porch . ................
Retaining Wall ...........
z
0
Slab Insulation ..........
0
PLUMBING:
Underground .............
-4
Rough -in
C ITI
IT 0
Commercial Final
0
0
HEATING:
C:
M
Gas Test ....................
M Z
g) -I
z
Gas Piping .................
Equipment .................
0)
0 -n
Commercial Final
EXTERIOR SHEATHING
M M
NAILING .........................
0
0
FRAMING ........................
0 M
FIRST FLOOR FRAMING
C C)
K (D
Q 0
INSULATION ...................
Z r-
Floor Insulation
Wall Insulation ...........
z
Ceiling Insulation
W
SHEETROCK NAILING
z
SPECIAL INSPECTION
IT
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..............
ROxi