20060010.pdfDATE RECE"'.
CITY OF EDMONDS
PERMIT
NUMBER ,2Z047 19,-)Id
CONSTRUCTION PERMIT APPLICATION
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OWNERNA EJNAMEOFSUSINESS
ADDRESS
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P�T NAME!SUBDIVISION NO Or 10, LID NO
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YES 13 NO C3
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REMARKS
0 NERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLjORAINAGE
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ENGINEERING REVIEWED By DATE
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PUBLIC WORKS REVIEWED BY 01
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STATE LICENSE NUMBER EXPIRATION DATE
FIRE REVIEWED BY DATE
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VARIANCE OR CU SHORELINE OR ADS. INSP ECTION S"A
PROPERTY TAX ACCOUNT PARCEL No
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ADDITION 0 CHANGE OF USE
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LOT COVERAGE RE UIREOSET ACK (FT) OFOSED SETBACKS 15T.)
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ALLOWED PROPOSED FRONT SIDI RIAI
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GRADING CYGS
REPAIR X_ FT.)
PARKING LOTAIIA PLANNINGREVIEWE11Y DATE
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DEMOLISH TANK OTHER
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A PORT ROCKERY F R ALARM
REMARKS
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GEOTECH REPORT
BY
STRUCTURAL DESIGN
By ei CHCVq 414-4.S 06—*
$
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Description FEE Description FEE
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Plan Check State Surcharge
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HEAT SOURCE LOT SLOPE', VESTED DATE
Building Permit City Surcharge
PLAN CHECK NO:
0
Plum,mg Base Fee
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THI PERMIT AUTHORIZES ONLY THE WORK NOTED. THISPERMITCOVIR WORKTO
Mechanical
TE PUBLIC
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION 0. TN PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC., WILL REQUIRE
SEPARATE PERMISSION,
GracliIng
PERMITAPPLI ATION: SEE ECDC 19.00.005(A)(5)
PERMIT LIMIT. SEE ECDCA9.00.005(A)(6)
Engr. Review Recording Fee
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection Plan Chlk. Deposit
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Fire Review Receipt 7 7,,Q
IN INTEREST,
2 EDMONDS, WASHINGTON, ITS FFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS F R DAM GES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection Total Aml Due
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."
Landscapeinsp. Receipt 0
APPLICATION APPROVAL
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THATTHE IN' R.ATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
CALL T � .1pl-1— '� - A P-Irel 11 �19n-d -1 In
T E OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
'uId, OM I a, h.,,e,, D,p,ty and FIB, an, P..a. a.d
FOR INSPECTION
TIO N; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOY ED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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WORKMEN COMPENSAJID"
��_YFAN � NORCW18:27.
(425) OFFICIALS SIGNATURE DATE
R� (OWN DATE SIGNED
R OR
771-0220
A
44
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EXT. 1333
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ATTE TION If 1--,eely4el ///
IT IS UNLAWFUL TO USE OR &-etrf�Y A BUILDING OR STRUCTURE
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL FiLE YELLOW 1111EITCH
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC110 FINI OWNER GOLD ASSESSOR
PRESS HARD YOU ARE MAKING 4 COPIES
6005
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall ..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOORIFRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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