20051092.pdfUSE
ZONE PERMIT
CITY OF EDMONDS NUMBER
CONSTRUCTION 'PERMIT APPLICATION JOB JJ SUITE/APT a
OWNER NANIEiNAME OF BUSINESS ADDRESS
A
LEGAL DESCRIPTION CHECK SUBDIVISION NO LID NO
MAILING ADDRESS
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0 Ole, 6 PUBLIC RIGHT OF WAY PER OFFICIAL STRE . ET MAP TESCP Approved 11
CITY ZIP I TELEPHONE NUMBER RW Permit Required 13
CD tn vA) —"I 744C EXISTING — REQUIRED DEDICATION Street Use Permit Req'd 0
PROPOSED Inspection Required 0
NAME Sidewalk, Required 11
METER SIZE AQ.QLF)=8T —IR Lu
LLU) ADDRESS Type . B 0 L vent co nectviis�equired
REMARKS
on fuel -burning appliances passing
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NAME
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ADDRESS
ENGINEERING MEMO DATED REVIEWED BY
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Z J03 2 1,q 2-5 -775- FIRE MEMO DATED REVIEWED BY Lu
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STATE LICENSE NUMBER EXPIRATION DATE
D&Vitlo� Pth�) 44 0. 1 - -2- 70 VARIANCE OR CU ADB# SHORELINE #
Legal Description of Property - include all easements SEPA REVIEW SIG N AREA HEIGHT
Z r COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED OPOSED
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Tax Account LOT AREA PLANNING REVIEW BY DATE CL
Parcel No.
REMARKS
NEW RESIDENTIAL PLUMBING/MECH
COMPLIANCE OR
0 ADDITION El COMMERCIAL CHANGE OF USE
FIREMODEL 1-1 APT. BLDG. El SIGN
HECKED BY TYPE1800CM)NSTRUCTION ICODE OCCUI�"T
GRADING FENCE GROR
0 - CYDS, El x _FT)
REPAIR I k� I
WOODSTOVE SWIM POOL SPECIAL INSPECTO OCCUPANT
DEMOLISH INSERT HOT TUB/SPA REQUIRED 0 LOAD
EGARAGE RETAINING WALL/
] CARPORT E] ROCKERY RENEWAL REMARKS L
0 (TYPE OF USE. BUSIN SSI ACTIVITY;)(XPLAIN: PROGRESS INSPECTIONS PER UBC 108 C
NUMBER OF CRITICAL
Lu NUMBER
0 OF DWELLING AREAS
M STORIES 041 UNITS INUMBER
0
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
F14 PEWA C e SPECTION REQUIRED
1�j LtLe f�� L4xE VALUATION FEE
IUAW ' 0"
FEE
BUILDING '72
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A) 6- PLUMBING
Plan Check. No. MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewelks,
driveways, marquees, etc.) Will require separate permission. STATE SURCHARGE
Permit Application: 180 Days I
Permit Limit: I Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns an ENG. INSPECTION FEE
successors in interest, agrees to indemnify, defend and hold
'Lnu harmless the City of Edmonds, Washington, its officials
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m employees, and agents from any and all claims for damages
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whatever nature, arising directly or indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
0 nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
T . �717,q
pr ovision." -7 ID
I hereby acknowledge that I have read this applica;io I at the ATTENTION APPLICATION APPROVAL
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 THIS PERMIT This application is not a permit until
state laws regulating construction; and in doing the work authoriz- AUTHORIZES
ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her
Code of the State ojA��gton relating to Workmen's Compensa- WORK. NOTED Deputy; and fees are paid, and receipt is
tion Insurance INSPECTION acknowledged in space provided.
SIGNAT (OWNIER 0 WAGE DEPARTMENT N � a
CITY OF C�AF)CNAL'S VGNTURE DATE
JDATE SIGNED
EDMONDS los
REI.EjEjBY Q DATE
CALL FOR
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE ORIGINAL — File YELLOW — Inspector
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771 = 0220
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC
SECTION 109 PINK — Owner GOLD — Assessor
102-87
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SETBACKS ............. ......
FOUNDATION:
Footing.....................
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Retaining Wall ............
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Slab Insulation ............
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PLUMBING:
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HEATING:
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Gas Test ......... .......
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Gas Piping ............
Equipme nt ................
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Commercial Final .........
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EXTERIOR SHEATHING
NAILING. ...................
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FRAMING ......................
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INSULATION:
Floor I nsulation ...........
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 ..........