20060166.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
;�;;1111111 OF BUSINESS
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ING ABUSE S
SL�TELEPHONE
NAME
PERMIT EXPIRES
DEE PERMIT
IONE NUMBER,�
76-.-
PLAT NAMEISUDDIVISION NO LID NO
I'D I!E I
"Ver,
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
U.. Pr_
EXISTING - PROPOSED- r- AM—"
REQUIRED DEDICATION- F'T
YEPRI REQUIRED
1 13 No 13
REMARKS
DWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
FIRE REVIEWED BY
BIT REVIEWED By
DATE
;OE
STATE LICENSE NUMBER
EXPIFIRATION DATE
BY
VARIANCE OR CU I
SHOIIIINIOIIA181 I
SHORELINE 0"'
INIPEI
SEC
OKED
[3YES
SEPA REVIEW
COMPLETE EXEMPT
V
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
ZjL;�
PROPERTY TAX ACCOUNT PARCEL NO.
S 3ol L CQ4,0 I
EXP ,
,
,
LOT COVERAGE
REQUIRED SETBACKS (Fr.)
REQUIRED BE
PROPOSED SETBACKS (FTI
NEW ��RESITD ALL
'-'
PLUMBING / MECH
ALLOWED PROPOSED
'E.-T SIDE REAR
FRO,
FRONT., URSIDE REAR
COMM A
ADDITION ER-
[3
R
COMPLIA CE OR
13 CHANGE OF USE
PARKING
LOT AREA
PLANNING REVIEWED By DATE
IA7.
REMODEL L, 'Y
SIGN
D PROVIDED
RED, IDED
E.. PROVIDED
REPAIR GRADING ... E] FENCIt
I X Fri
REMARKS
DEMOLISH TANK
07HER
GARAGE o RETAINING WALL
F L BE
C REPORT ROCKERY
F:SESPRINK
RE ALARM
(TYPE OF USE, BUSINESS.OR AParIVIM XPLAIN:
CHECKED BY
TY
---------
NUMBES
OF
NUMhER OF
I ELLI.G
I CRITICAL
AREAS
SPECIAL INSPECTION AREA
STOR JES
UNITS
NUMBER
REQUIRED 0 YES
DESCRIBE WORK TO BE DONE
3
$
I
-
Description
FEE
Description
FEE
Plan Check
State Surcharge
HEIO SOUSCE GWINO I LOT SLOPE
Building Permit
City Surcharge
F_1,w_vf-f C,
PLAN CHECK NO: VESTED DATE
Plumbing
Base Fee
Mechanical
THIS PERMITAUTHORIZES ONLY THE O.KNOTED. THIS PERMIT COVERS WORK TO
t: 1110"11" 11111 1"IFERTY 1"I ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS. S1DEWAtJrS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
L — SEPARATE PERMISSION. -
Engr. Review
PERMITAPPLICATI N: IBODAYS
PERMIT LIMIT. I YEAR - PROVIO D WORK IS STARTED WITHIN IGODAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Fire Review
Plan Chk. Deposit
'APPLICANT, ON BEHALF F HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY DEPEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt 0
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY On INDIRECTLY
FROM THE ISSUAN E OF T IS PERMIT, ISSUANCE OF THIS P T SHALL NOT BE
C
Landscapelnsp�
Total Arm Du
D11M11 To MOD, FY WAIVE OR REDUCE ANY REQUIREMENT OFEASM' CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORD1,01
Recording Fee
aceipt #'
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
Ijj.. io net . p-11 0 Mond by In.
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CO NSTRUC.
CALL
L.P. D,pWy; a,d Fees Oro POb, 0
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 u,..1pHo..kr.wP.dgodH..p ... P—Id-d
WORKMENS COMPENSATI:=CE AND RCW 18 7.
SIGNATURE OWNER 94 AGENT) DATLI"NEO
(425)
!IAIIIGNA �RETE
771-02r-U
ATE
RELEASEd BY UrATC
ATTENTION
�l
EXT 1333
ITISUNLAWFULTOUSro PY lit DING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVALOR ACERTIFICATE OF OCCU-
ORIGIN' -FILE YELLM- INSPECTOR
PANCY HAS BEEN GRANTED. UBCIO9/IBCl10/IRCII0.
PINK -OWNER GOLD -ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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Permit Inspection Details
Permit: BLD20060166
PERMIT'-1;�,k
10Y,8 E.Pee-DernblitlowSew�rc;i��::
co" im"PI'Mp'!
:�:V 'Y'
04/28/2006 jh 16 Sewer capped by OVWSD
Total Time:
10
107*_.'. t-Prei-ij�rno Watel`S,erV, DIs&int:t/AVB,
Cont ete?
04128/2006 ih 10 Water meter removed by OVWSD
Y
Total Time:
10
1660 -�Jlt�Pri-Dem6:Erosicm Coniti6l
complete,
',Y� r
04r�al�66-6 jh 10 TESC per City std's
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Total Time:
10
ingfinaUD
108 E;En in eti erno�,
c- , ?
orn 109
Pt
0
_91 'M
07/1412006 jh 30 Final demo complete
Y
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Total Time:
30
11m �64-re D&hollfion
04/28/2006 MS 20 PRE -DEMO APPROVED
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Total Time:
"
20
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08/25/2006 JLG 0 APPROVED
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Total Time:
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Total Inspections: 6
Total Time;
80
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7/912009 9:40:48 AM Page I of I
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .............
FOUNDATION:
Footing ......................
Wall ..................
Pier/Porch .................
Retaining Wall ...........
z
Slab Insulation ..........
PLUMBING:
Underground .............
74 _n
Rough -in ...................
M
C:
Commercial Final
ITI 0
0
-40
HEATING:
0 C
Gas Test
IT
M
0
Gas Piping .................
-4
Equipment ...........
Commercial Final
0
-n
EXTERIOR SHEATHING
-4
x
NAILING .......................
M M
a
FRAMING ........................
0
0 M
FIRST FLOOR FRAMING
C (n
(j)
M C-)
INSULATION ...................
Z r-
71
Floor Insulation
;a
-4
Wall Insulation
Ceiling Insulation
z
SHEETROCK NAILING
(A
z
SPECIAL INSPECTION
0
ITI
MISCELLANEOUS ..........
FINAL APPROVAL FOR
"� �,ee
OCCUPANCY ..............
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