20060388.pdfDIE R1111110
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER
ILI.G ADDRESS
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CITY �. ' ZIP I TELEPHONE
NAME
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TELEPHONE,,,,
PERMIT EXPIRES 117�
PERMIT
IN .. E.
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ADDRESS
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FLAT NAIAE�SUBDIVISION NO
LOT No
LID NO
LID FEE S
PUBLIC FIGHT OF WAY PER OFFICIAL STREET MAP
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EXISTING . . . PROPOSED
REOUMEDDED1CANON___FT___
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METER SIZE
LINES1717.11IXTUF�.
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION rONTROUDRAINAGE
FIRE MARSHAL
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PROPERTY TAX ACCOUNT
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MIXED USE
CHANGE OF USE
Lo"CoVERAGE
ALLOWED PROP....
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REQUIP. BE I
FRONT SIDE HEAR
I PROPOSE. SETTA�CK,�IEII I
AT
FRONT URSIDE H
REMODEL
MULTIFAMILY__
13 "IF'
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REPAIR 0 GRADING CYDS
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REMARKS
AIRPORT ROCKERY
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REALARM
(TYPE OF USE. BUSINESS OR ACT
NUMBER
NUMBER OF
OF
M STORIES
WELLING
UNITS
UIAPIT
REQUIRED E3 YES
Description
Script'
FEE
Description
FEE
HEAT SOURCE VESTED DATE
Plan Check
State Surcharge
L" � Rm.
Building Permit
C'm
city surcharge
PLAN CHECK NO:
Plumbing
Base Fee
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THI PERMITAUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
ON TH. PU
ON He P
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION T USLIC
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a a ca
Mechanical
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
Grading
SEPARATE PERMISSION.
PERMIT APPLI ATION; SEE ECDC 19,00-StAHS)
PERMIT LIMIT. SEE ECDC 19,00.005(A)(6)
Engr, Review
Recording Fee
Eng, Inspection
Plan Chk. Deposit
SEE BACK OF PINK PERMIT FOR MORE INFO=N
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
--;;7—
re RoVeW
Receipt AT
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
E EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
AIAL OL41MS FOR DAMAGES OFWHATBIER NATURE, ARISING DIRECTLY On INDIRECTLY
ISSUANCE OF THIS PERMIT SHALL NOT BE
_�,. Inspection
Total Amt. Due
FIR M THE ISSUANCE OF THIS PERMIT.
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscape losp.
Receipt It
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
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
CALL
Th� -.1 �K` B, IIX`
THE OWNS . I AGREE TO COMPLY WITH CIT AND STATE LAWS REGULATING CONSTRUC-
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FOR INSPECTION au"_9OK", _� AP�I, — 1�. — R
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LADD OF THE STATE OF ASHINGTON RELATING TO
I—P, �P P,.B
WO�^NSATIO.YSU`.OAEICE AND ACW 18i27.
(425)
OFFICIALS$ ' U E DA7
NATU W OR T
771-0220
AELEASE618Y
EXT. 1333
A tE A
ITTSutl'ITTOUSEOROCCUPYA BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTI-
ORIGINAL -FILE YELLOW INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110,
PIN� -OWNER GOLD - ASSESSOR
6105 PRESS HARD - YOU ARE MAKING 4 COPIES
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Permit Inspection Details
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11/2712006 SMITHM 0 OK
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ...................... ..
Wall................... . .....
Pier/Porch .................
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Retaining Wall ...........
Stab Insulation ..........
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PLUMBING:
UndergrouM
Rough -in ...................
M
C:
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Commercial Final
0
HEATING:
X IT
Gas Test .............
C: _Z
Gas Piping .................
>
Equipment ................
0
Commercial Final
"n
x
EXTERIOR SHEATHING
M ITI
NAILING ..............
C) a;
0
FRAMING ..............
0
C Cf)
FIRST FLOOR FRAMING...
0
INSULATION ...................
Floor Insulation
Wall Insulation ...........
>
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Ceiling Insulation
SHEETROCK NAILING
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$
SPECIAL INSPECTION
0
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
0