20050799.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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D I I PERMIT EXPIRES
PERMIT
NUMBER
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ADDRESS *7 -7
PLAT NAME)SUBDIVISION NO, LOT NO L
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D FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED
REQUIRED DEDICATION FT
METER S12E I LINE SIZE I NO, 01 IIXTURIS P V REQUIRED
YEsI3 NO 13.
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
By
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FIRE REVIEWED BY
DATE
CITY
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TELEAHONE
VARIANCE OR DO
SHORELINEGRADD!
INSIPEEOTION
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SEPA
COMPLEIED EXEMPT
STATtj!�CNSE NUMBER EXPIRATION AT B
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NOI I
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SIGN AREA
HEIGHT
PROPERTY TAX ACCOUNT
PARCEL NO.
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'ALLOWED VPERROAIGOEIII
REQUIRED SETBACKS JFT.� PROPOSEDS
FRONT SIDE BEAR FRONT
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11111 FEAR
ADDITION
COMMERCIAL
COMPLIANCE OR
I
MIXED USE
CH -GE OF USE
A
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PARKING
LOTIRIA
PILANNING REVIEWED BY DATE
0 MULTIFAMILY
SIGN
REDID
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GRADING
FENCE
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11B-I.EC
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( — X—FT)
REMARKS
DEMOLISH
TANK
OTHER
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GARAGE
CARPORT
RETAINING WALL
ROOKERY
I ESPRINKLER
FIR
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(TYPE OF USE, BUSINESS 0 A C To N
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PANT
RCUuP
NUMBER
HUM
ER OF
OF
DWELLING
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SP IAL INSPECTION
I CONSULTANT
OO1UPANT
TORIES 0h
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LOAD
DESCRIBE WORK TO BE DONE
REQUIRED YES
REMARKS
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GEO ECH REPORT
'SYN
CTURAL DESIGN
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VALUATION
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Description
FEE Description FEE
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Plan Check
State Surcharge A-"Z
H�t SOURCE LOTSLOPE% VESTED DATE
-77--
a�y
B.ilding Permit
E��rcharge
PLAN VECK NO:
Plumbing
Base Fee
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
ON THE
ON PUBIC
BE DONE ON PRIVATE PROPERTY ONLY� ANY CONSTRUCTION ON THE PUBIC
ETC I WILL REQUIRE
DONMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
Grading
SEPARATE PERMISSION.
PERMIT APPLICATION: SEE BODO 19.00.005(
A. SEE a PERMIT LIMIT. SEE ECDC 19.00.005(A)(6)
.AT,.N
ACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
'APPLICANT, ON BEHAL 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
I EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
AL CLAIMS 1011 DAMAGES OFWHATEVIR NATURE, ARISING DIRECTLY OR INDIRECTLY
FR M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
D EMED TO MODIFY, WAIII E OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapeinsp.
1111 Anti, DUE,
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Recording Fee
Receipt # PIZ,_
I HEREBY ACK O-EDGE THAT I HAVE READ INS ABB11C.I..; THAT THE INFORM TION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
The ppl-honet net A ehhhe urhle,ghthl by the
C
T E OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING ONSTRUC.
CALL
Behh, OMPMI ., h,.Ih., )Vp.ly� And F p.d. hd
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMP DYED
IN VIOLATION OF THE LABOR CODE OF STATE OF ASHINGTON RELATING TO
FORINSPECT17
hOn-led,.- Np, —d.d,
WORKMEN' EN A IN E AND RC
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771-0220
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S OF D
AfrENTION
EXT. 1333
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
0 GIN L FI E - YELLOW , INSACTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 I ISC110 / IRC110.
NK -OWN - GO D . ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ..................
wall ................
Pier/Porch ...........
Retaining Wall
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Slab Insulation ..........
PLUMBING:
Underground ............
Rough -in ...................
3:
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Commercial Final
M 0
0
0
HEATING:
C:
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Gas Test ...........
3: M
M z
10
Gas Piping .................
Equipment ..................
3:
t Commerclai Final
0 -n
-n X
EXTERIOR SHEATHING
NAILING .............
M M
I FRAMING ........................
0
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FIRST FLOOR FRAMING
R.,
i INSULATION ..........
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71 r-
Floor Insulation
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Wall Insulation ...........
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Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................