20050885 (2).pdf114
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IVED
10 ERMIT EXPIRES
U�. E PERMIT
CITY OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
ADDRESSZ., jii�L /0
OWNER NAME/N4ME /qt,;E �
BUSINES6
PLAT NAME/SUBDIVISION NO LOT NO. LID NO
M M;AILING �AD RrSSr LID FEE S
W
z I ESCP Approved E3
3. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required 13
ci b C) I PW if Street Use Permit Roq'd 0
CITY ZIP TEIFPHONE EXISTING - PROPOSED Inspection Required 13
Sido�alk Roquitod 13
REQUIRED DEDICATION- FT Undefgroi,nd
7 7 A!R-31-6 y wiring r0qL1,rod [3
NAME METER S14E REQUIRED
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NAME CBL#
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CC ADDRESS
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STATE LICENSE NUMBER EXPIRAI ION DIE CHECKED ELY
/ I OYES EINOI$
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LCA� -H I LS� q `7 1 I�A SEPA REVIEW SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. OSED ALLOWED , PROPOSED
COMPLETE EXEMPT ALLOWED
PROP
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...............
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
NEW RE6I0&4TJAL-- PLUMBINCJ�/M�ECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR
X_ X T z
ADDITION COMMERCIAL _1 COMPLIANCE OR GAS IPE EST 11AUS1 BE 2
El r CHANGE OF USE z
PARKI GI 01 OR DATE
REMODEL MULTIFAMILY SIGN REO'D I P%UTjVt0R6 iU+*
'12r, FENCE A EIDAVI S SHALL NOT
REPAIR GRADING CYDS ( — X F-T) REMARKS BE ACCEPTED
DEMOLISH TANK OTHER
GARAGE RETAINING WALL FIRE SPRINKLER
z CARPORT ROCKERY El FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: OCCUPANT
CHECKED 13Y )E
c0VI 00 GROUP
_IAPF OF
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uj NUMBER NUMBER OF CRITICAL
OF DWE AREAS SPECIAL INSPECTION JAREAJ OCCUPANT
ILLING 0/1 NUMBER LOAD
0 STORIES UNITS REQUIRED [:] YES
DESCRIBE WORK TO BE DONE
REMARKS z
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RECI'D
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Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE LOT SLOPE %
a 4 y I GLAZING % Building Permit City Surcharge
PLAWCHECK NO: VESTED DATE Plumbing 12,C) Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 2--D
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: ISO DAYS
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PERMIT LIMIT 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
(A
ui 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 Receipt #
, 4 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
C
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF I HIS PERMIT SHALL NOT BE
0 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due
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01 NOR Llh-10 IN ANY WAY THE CITYS ABILIFY TO ENFORCE ANY ORDINANCE PROVISION.-
c Ipt
Recording Fe LReceipt #
I HEREBY ACKNOWLEDGE THAT 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
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Olficial or his/her Deputy: and Fees arc paid, and
IN VIOLATION OF THE LAHOH__CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INS4RANCE AND RCW 18.27. DATE
OFFICIALS SIGNATU�E
SIGNA DATE SIGNED (425)
;URE (OW�NE , !"�
L�N
77�) -7 ILOLJ DATE
12� 771-0220 EASECi-BY
ATTENTION EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
z
Retaining Wall ........... 0
Slab Insulation .......... 0
PLUMBING:
Underground .............
OM
Rough -In .......... C
M
0
Commercial Final ......
0 C:
HEATING:
M
M Z
Gas Test ....................
C
Gas Piping .................
Cn
Equipment .................
0 -n
Commercial Final .......
x
EXTERIOR SHEATHING M M
NAILING ..........................
0
FRAMING ........................ 0 M
C: Cl)
C0
FIRST FLOOR FRAMING ... Q 0
Z
INSULATION ...................
Floor Insulation .........
>
Wall Insulation ........... z
Ceiling Insulation ....... x
Cn
SHEETROCK NAILING ... z
0
SPECIAL INSPECTION
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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