20050820.pdfFDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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STATE LICENSE NUMBER EXPIRA1
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PROPERTY'r :OPNJ PARCEL NO.
NEW RESIDENTIAL
Cj ADDITION COMMERCIAL 10
MIXED USE
REMODEL D MULTIFAMILY
REPAIR GRADING CYDS
DEMOLISH TANK
GARAGE RETAINING WALL
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(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
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51 STORIES UNITS
DESCRIBE WORK TO BE DONE
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PLUMBING / MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
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( — x —FT.)
OTHER
FIRE SPRINKLER
FIREALARM
PERMIT EXPIRES L:M
PERMIT -A <_
NUMBER c9LCC 5—
JOB SUITI
ADDRESS
PLAT NAME)SUBDIVISION NO LOT NO, LID NO
PUBLI�Rloi�rOF �YPMJFFINAWiRR=Apectors rCA1Vd1W:,
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5pection Required
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NO OF FI3ff_U_R`Es____7R_VTMWIRED
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REMARKS W
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OWNERiCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 10
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ENGINEERINCREVIEWCO"B�Y'--"""-' te re DATE
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FIRE REVIEWtIVft%t"_" DATE W
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REO'D I COMPLETED I EXEMPT
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CAN
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SIGN AREA
HEIGHT
WAIVER 13
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ALLOWED PROPOSED
ALLOWED PROPOSED
1
STUDY 13
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LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
FRONT
SIDE REAR
FRONT URSIDE REAR
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PARKING
LOT AR
PLANNING REVIEWED BY DATE 15
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REQ 0 1 PROVIDED
REMARKS
CODE OCCUPANT
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SPECIAL INSPECTION CONSUL
REQUIRED 13 YES
REMARKS
GEOTECI I REPORT
BY:
STRUCTURAL DESIGN
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VALUATION�
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Description
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Plan Check
HEAT SOURCE
LOTSLOPE%
VESTED DATE
Building Permit
PLAN CHECK NO:
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Grading
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
2—
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(6)
Engr. Inspection
uj
IL PERMIT LIMIT. SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
Fire Review
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IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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2
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Landscapeinsp.
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. -
Recording Fee
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
WORKMEN'S C I OMPENSATP��*SURANCE AND RCW 18:27.
132YE ZSNED
SSIGNA);d�E (OW E MOR� L 4 - a' (425)
771-0220
OTENTION 1=,& L I JJJ
ITIS UNLAWFULTO USE OROCCUPYA BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC1091 IBC110 / IRC110.
OCCL
LOAD
FEE Description
State Surcharge
City Surcharge
ir,—y'), Base Fee
FEE
Plan Chk. Deposit
Receipt #
Total Amt. Due
Receipt #
APPLICATION APPROVAL
This application is not a permit until signed by the
Building Official or his/har Deputy: and Fees are paid, and
receipt is acknowledged in space provided.
t: i Rm&-r, , i r. N IT tj)R F I I DATE 1
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
DATE
ORIGINAL - FILE YELLOW - INSPECTOR
PINK -OWNER GOLD - ASSESSOR
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