20050750.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
MAILINGADDRESS
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L12 I I PERMIT EXPIRES g-j
PERMIT 229 1
N UMBER
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ADDRESS bc ZOS IN E-_
PI -AT NAMEiSUBDAIISION NO, LOT NO Ll NO
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED
REQUIRED DEDICATION FT
MEIER SIZE I LINE SIZE I NO� 01 IIXTURIS YEP VRIGUIRED
SO NoO
REMARKS
OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROLIORAINAGE
NEW
RESIDEN IAL
rl PLUMBING I MECH
ADDITION
COMMERCIAL
COMPLIANCE OR
n
MIXED USE
CHANGE OF USE
REMODEL
MULTIFAMILY
n SIGN
qg REPAIR
E] GRADING GYDS
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[3 DEMOLISH
TANK
ETAI
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CARPO;T
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OR ACTIVITY)EXPI.Aft
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NUMBER
NUMBER OF
M OF
STORIES
DWELLING
UNITS
FIRE REVIEWED BY
DATE
VARIANCE OR CU
HOPE
5 LINE On E?B
INSPECTION.1
SERA
11 61 99- b"! -
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STUDY 10
2AV
LOT COVERAGE
RED IRED
SETBACKS FTt
PROPO
ED BE BACKS (FT.)
ALLOWED PRO
NT SIDE REA(FT'
R.NT
FRONT UPSIDE REAR
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F`N�51 1 ol I 'a'
N o Ch a riq,-e-
PARKING
UOTAREA FL NNINGREVIEWEDBY DATE
REQ`D I'FOVIDED
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REMARKS . I ,
A
TYPE r GR
�RUCTION OC.,UPANT
P
SPECIAL INSPECTION I CONSULTANT
REQUIRED 13 YES
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$ 6, 1)0(p
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Description
FEE
Description
FEE
A, rs c'j
Plan Check
StaleSurcharge
I;a
HEATSOURCE ILOTSLOPE%
VESTED DATE
Building Permit
City Surcharge
PLAN CHECK NO: bs-Z82'
Plumbing
BBB Fee
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
Grading
85 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU BIC
D.NNAIN JCURRS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,1 WILL REQUIRE
SEPARATE PERMISSION.
Ehg,. Rev
I C
PERMIT APPLICAT ON: SEE ECO 19.00.00S(A)(E)
I, n9r. Inspection
PERMIT LIMIT. SEE IECD. 19 00'006(A)(6)
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
'A P ]CANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
P L
Fire R.,i.w
Plan Chk. D.p.si
INTEREST, AGREES TO RIDE NIFY, DEFEND AND HOLD HARMLESS THE CITY OF
11 EDMONDS , WASHINGTON, TS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS F R DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt # Me
2
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT Be
CITY ORDINANCE
Landscapelnsp.
Total Amt. Due 7&
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
Recording Fee
Receipt #
IMERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT T EINFORMATION
APPLICATION APPROVAL
H
GIVEN IS CORRECT; NOTHATIAM THE OWNER�ORTHE DULYAUT ORIZEDAGENTOF
Thl. appkalb, - , p,,I,t Ild sign,d by IA,
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
B.,Ib,ng Off -I .1 rb� D.,ul, bd F A,. Ibld, ..P
,ION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
.... Ip- m-wiedged In spIce provided
FOR INSPECTION
IN VIOLATION
WORKMEN'S COMPENS=NC5 AND RCW 111 7.
DATE
DATE SIGNED
st]al�ajj
(425)
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1
4 & 44Q /0
Lj
771-0220
AIEASED.Y
ATTENTION
EXT. 1333
ITISUNLAWFULTOUSEOROCCUPYA BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI.
ORIGINAL - FILE - YELLOW - R/RECT04
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 I IBC110 I IRC110.
PINK . OWNER - GOLD - ASSESSOR
101" PRESS HARD -YOU ARE MAKING 4 COPIES
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing .............
wait.1 ........................
Plot/Porch .................
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Retaining Wall ...........
0
Slab Insulation
PLUMBING:
Underground .............
IT
C
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Rough -in
0
...................
0
C
Commercial Final
C I I
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HEATING:
jo -1
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GasTest ....................
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Gas Piping .................
Equipment ...........
0
ri
Commercial Final
M ITI
0 �j
EXTERIOR SHEATHING
0
NAILING ..........................
0
C
FRAMING ........................
IT 0
FIRST FLOOR FRAMING
Z
;13
INSULATION ............
_11
Floor Insulation
:C
>
z
__11
Wall Insulation ...........
Calling Insulation
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SHEETROCK NAILING
0
IT
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
56/1
6-36Y
oID06-075-0