20060217.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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STATE LICENSE NUMBER EXPIR4TION DATE I CHECKED BY
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REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROIJOR MADE
FIRE REVIEWED BY
DATE
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SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED
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Lo COVERAGE REQUIRED SETBACKS (Fr.) PROP 0 SETBACKS ("I
ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR
PARKING LET AREA I PLANNING REVIEWED BY DATE
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REMARKS
PROGRESS INSPECTIONS PER USC 1108/1FINAL INSPECTION REGO E 9
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Description
FEE
—
Descripti In
FEE
ADATE
Plan Check
State Surcharge
HEAT SOURCE GLAZING
LOT SLOPE X
Building Permit
City Surcharge
PLAN CHECK NO: VESTED
Plumbing
Base Fee
Mechanical
THISPERMITAUT ORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
8. DONE ON PRIVATE PRCIPER� ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
3
Grading
SEPARATEPERME SSION.
Engr. Review
PE VITAPPLICATION: ISODAYS
PERMIT LIMIT. I YE,kR - PROVIDED W RK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLI ANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk, Deposit
I. INTEREST, AGREES To INDE.181 DEFEND AND HOLD H RMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt #
FROM THE ISSUANCE OF THIS PERMIT ISSUANCi OF THIS PERMIT SHALL NOT BE
D EMED TO MODIFY, WAIVE OR RED CE ANY REQUIREMENT OF ANY CITY ORDINA OF
E U
Landscapainsp.
TbtalAmt.Due L
o NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
... . ...........
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APP ICATION APPROVAL
T E OWNER. I AGREE TO COMPLY WITH CI AND STATE LAWS REGULATING CONSTRUC,
CALL
Thppfi�fl.. I, n.l. p.-II-til Mgmd by th.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE 0 WASHINGTON RELATING TO
B.11,11na Offid.1 ., hWhI,, Op.ty: nd F — p1d, tId
FOR INSPECTION Ip,Ia.k.-I.dg.dHp ... pld.d.
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WORKMEN'S COMPENSATION INSURANCE AND RCVV 18.27�
�GNATUII O� DATE SIGNED
(425)
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771-0220
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R.EEA§. EIr
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL . FILE - YELLOW . INSPECTOR
PiNK-OWNER - GOLD -ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DAT
—ENGINEERING DIVISION DATE
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PLANNING DIVISION DATE
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PROJECT 0 4- r) A,,' -?A L_ Z-
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pERM1T#-d,06(,—Cy�_1--1 __AD]3# ...... DATEINSPECTED
DESCRIPTION OF WORK TO BE INSPECTED IPUIL-IiO
A field inspection was conducted to determine compliance with approved plans. Final approval
denotes that there are no objections from the above signed Depart It to the release ' of
PERFORMANCE BONDS nd the granting of: [7SL_16'�t-lo�e
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GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:forms:ocaprv1 3/25/04
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Permit Inspection Details
Permit: BL020060217
PERMITTPAX
.. ........ .
03/28/2006 smith 20 APPROVED
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Total Time: 20
Total Inspections; 1
Total Time: 20
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Page I of I
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS
FOUNDATION:
Footing.................
Wall ..................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
ITI
Underground .............
Rough -in ...................
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Commercial Final
C:
IT 0
HEATING:
-40
0
0 C
Gas Test ....................
IT! M
Gas Piping .................
C Z
Equipment .................
Commercial Final
0
EXTERIOR SHEATHING
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NAILING ............... ..........
-4
x
ITIM
FRAMING ..............
0
0
FIRST FLOOR FRAMING
C co
INSULATION ............
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Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
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ITI
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY