20060167.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
IER NAMEINAME OF BUSINESS
CITY ZIP
-74
ADDRESS
N FIRE REVIEWED By
,0:57 1
II STATE LID NIS NUMBER '; �7;7;& 17 1
wz z 1'��W"L? /D/'
E] NEW
[3 PLUMBING I MBCH
E] ADOITION
/WRESIDENTIAL
E] COMMERCIAL
COMPLIANCE OR
13 CHANGE OF USE
REMODEL
MULTIFAMILY
13 SIGN
REPAIR
[3 GRADING CYDS
ci F NCE
I X FT)
DEMOLISH
TANK
OTHER
GARAGE
RETAININGWALL
FR SPRINKLER
Fi ARPORT
ROCKERY
FIREALARM
(TYPE OF USE, SUSINESS,�;r
-
A
—
'ZMBEA
'ELAIN:
NUMBEROF
� . �
C
OF
DWELLING
AREAS vv
5" 4E
STORIES
UNITS
I IMBER 0
DESCRIBE WORK TO BE DONE I
A
PERMIT EXPIRES
US' PERMIT
ZONE NUMBER
JOB SUITEIAPT#
ADDRESS �"V�7
PILAT NAMFISUBDIVISION NO. I LOT NQ
I'D
D FEE $
Me, .11—a
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — pRcFOSED�
d
REQUIRED DEDICATION FT
METER SIZE I LINE Slii OF FIX�URES YES V REQUIRED
13
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINACE
:NGINEERING REVIEWED BY DATE
DATE
D
VARIANCEORCU I SHOHELINEOIIAOBI I INSPECTION 1. SON
RE 'D POSTED
OYES ONO
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED I 1R.1OSEO
OF
.XP I
LOT COVERAGE RS.UIRED SETBACKS III PROPOSED SETBACKS IFT)
R
ET.A -1 UR SIDE
ALLOWED PROPOSED FRONT SIDE BEAR FRONT HEAR
PARKING — AREA I PINNING REVIEWED BY DATE
RED'. I PROVIDED I
CHECKED BY ITYPEs
'j�C�ONSTUCT!ON
Ro
SPECIAL INSPECTION
REQUIRED JAREA LOAD
M YES OCCU
REO'D
I I Descriotion I FEE I Description I FEE I
IT a ck
Plan Check
P a C h
State Surcharge
T S
GLAZING ZT age %
Lo '0" %
ell= cl�
Building Permit
City Surcharge
VESTS 0 A T
PLAN CHECK NO: VESTED DATE
Plumbing
P In b I n g
Base Fee
-a G 'I a a'
Mechanical
R`
PERMIT COVERS WORK To
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
1 'ON a. THE PUBLIC
t: BE DONE ON PRIVATE PROPERTY ONLY. AW CONSTRUCTION ONTHE PUBLIC
Grading
Gmd Ing
2 G L
OMAIN (CURDS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
a
SEPARATEPERMiSSION. U
T.LandscapeInsp.
Engr, Review
RE MITAPPUCATION: 160DAYS
i,
PERMIT UMM I YEAR - PROVI 60 WORK IS STARTED WITHIN '80 DAYS
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
BUDGE...
'APPLICA ON BEHAL OF His OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire REV'_
Fire Review
Plan Chk. Deposit
I
T
1. UITE.-EST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS MOM ANY AND
Fire Inspection
Receipt #
ALLCLAIMS DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE IFOUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BF
DeEMEO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
To IT . Y., G I
sG.P sp.
Total Amt. Due
NOR LIMIT IN ANY WAY THE C"S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
Recording Fee I
Receipt P
I HERE 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 OWNS . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
I
applic, !on is not a ponnit-111 signed by Me
TIC) N; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
R,KTIaa
on T Fees .'a
dirsOlficialorheilho, p, and pa d, and
IN VIOLATION OF THE LAB R CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
ecolpthiankii-Iodg.dasp.o. ri—id.d.
WORKMEN'S COMPENSATI�=NCE AND RCW 18.27.
UBE DATE
SIGNATU�,E (OWNER O��dENWT)�
(425)
,�SjFA
�j
-0R11EA1i9-
771-0220
ATTENTION
EXT 1333
TISUNLAWFULTOUSEOROCCUPYABUILDINGOR STRUCTURE UNTILARNAL
NSPECTION HASBEEN MADE AND APPROVAL ORA CERTIFICATE OFOCCIJ
OR G NAL � FILE YELLOW - INSPECTOR
PANCY HAS BEEN GRANTED, UBC1091IBC1101IRC110.
P2K-OWNER GOLD ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
z
0
d
0
rn
C: 0
IT! 0
--1 0
0 C
4 K
= M
IT z
0 -4
C
0 -n
M A
0 Fn
I
0 'M
C
rn o
Z
z
co
z
9
0
IT!
Permit Inspection Details
Permit: BLD20060167
FERMITTP�NY,
Y.
04128/2g06 jh 10 Sewer capped by OVWSD
Y
Total Time: 10
10M� E!Pre-Demb Watier
0412812006 jh I0 V"tr meter removed by OVWSD
Y
Total Time: 10
6�/28`/2066 ih 10 TESC per City aid's
Y
Total Time; 10
..... ... ..... . ..
l08t-'EEh'g'1neer1 I;Tna� em 0-�
'c
0
07114r2OO6 1h 30 Final demo complete
Y
M
Total Time: 30
iz.
Y
04/28/2006 MS 20 PRE -DEMO APPROVED
Total Time: 20
ITI
/B1 I
"aa,
Ma
0
08125/2006 JLG 0 APPROVED
Y
0
0 C
Total Time; 0
K
IT
Total Inspections: 6
Total Time: 80
z
0 -n
'n
-4
IT M
0
OC
9 ca
M 0
C0
z
0
IT1
719/2009 9:39:41 AM
Page 1 of I
T�
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall ..........
Pier/Porch .................
Retaining Wall ...........
Stab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final
HEATING:
Gas Test
Gas Piping
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING .....................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ..................
Floor Insulation
Wall Insulation
Gelling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ............ ....
U,
&4
7
z
0
R1
1713
MID
—10
0 0
C
—4 C
=: M
ITI
C
0 _n
__4
1111 IT!
0,
0 M
C: C/)
9 CA
M 0
Z
z
co
z
0
d
0
ITI