20060407.pdfPERMIT EXPIRES
CITY OF EDMONDS
PERMIt
NUMBER
CONSTRUCTION PERMIT APPLICATION
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ADDRESS,�Z 1 &0 j .7
OWNER NAMEJNAME OF BUSINESS
PIUAT NAME�SUQDIVISION NO
LID NO,
LID FEE S
MAILING ADDRESS
21661
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED,
REOUIRED DEDICATION FT
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CITY ZIP
TILIPI 11
NAME
METER SIZE
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NO OF IIIIUA15
PRV REQUIRED
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ADDRESS
,35-00
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROQOSAINAGE
CITY - ZIP
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ITELEPRONE
NAME
ENGINEERING REVIEWED BY DATE
ADDRESS
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RECYCLE REVIEWED BY DATE
CITY ZIP
C,IG-
TELEPHONE
PUBLIC WORKS REVIEWED BY DATE
STATE LICENSE NUMBER
CHK5.1—
PROPERTY TA ACCOUNT PARCEL NO. -1
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FL COMPLIANCE OR
ADDITION
13 STUDY
VERAGE
LOT GO ED
ALLOWED RADIOS
REQUIRE SET ACK (FT) PROP
0 ` PROP
FRONT SIDE FEAR FRONT
BED SETBACKS F1
UPSIDE REAI
MIXED USE CHANGEOFUSE
REMODEL MULTIFAMILY SIGN
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REPAIR GRADING cyo� (FENCE X FT.)
PARKING
LOTAIEA
PLAN"N REVIEWEDBY DATE
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DEMOLISH [3 TANK 1-3 OTNE7
REDD i PROVIDED
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RETAINING WALL
GARAGE FIX R �NKLER
REMARKS
CAP PORT ROOKERY
(TYPE OF USE. BUSINE1W E PMN::
NUMBER
N MEER IF
TYPE 3;rUCTION
CODE
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0 CUPAN
GROUP
F
STORIES
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1 UNITS
DESCRIBE WORK TO BE DONE
SPECIAL INSPECTION
REQUIRED 13 Yes
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EMARKS
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GEO ECH REPORT
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Description
FEE
Description
FEE
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Plan Check
State Surcharge
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Building Permit
City Surcharge
15
PLAN CHECK NO:
Plumbin g
Base Fee
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THIS PERMITAUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
Grading
11/3�05'�aolll#
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SEPARATE PERMISSION.
SEE CCOC
PERMIT APPLICATION: 19.00.005(Ais)
PERMIT UMIT.� SEE ECDC 19,00.005(A)(61
Engr. Review
&Cop -t *
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Engn Inspection
Plan Chk. Deposit
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESSORS
Fire Review
Receipt 0
IN INTEREST, AGREES TO INDEMN fy, DEFEND AND HOLD HARMLESS THE CITY OF
I EDMONDS, WASHINGTON. TS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR IND R CTLY
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PERMIT SHALL NOT BE
Fire Inspection
Tall ARK
FROM THE ISSUANCE Of THI PERMIT. ISSUANCE OF THIS
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
_T;_ndSc Rep.
F
Recept
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY OR DINANCE PROVISION.-
]HERE Y 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
ThIS IPPI11,11111 -1 "11 P11111 L1111 11911d by Ih,
T E OWNER. I AGREE TO COMPLY WITH Cl Y AND STATE LAWS REGULATING CONSTRUC-
FOR INSPECTION Su�ldblg
Obileil D, hIll- Depty ald Fee, all P11d, Ile
TION; AND IN DOING THE WORK AUTHORIZED HEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF T R CODE OF THE STATE OF WASHINGTON RELATING TO
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ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
00RIGI.Iv. V
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI.
YELLOW - INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / JBCJJ0 I IRC110.
PINK -OWNER GOLD - ASSESSOR
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FINAL PROJECT APkOVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIR DEPARTMENT DATE_5�/—�66
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE
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PERMIT#Q_oar--d9o7 ADBft DATEINSPECTED
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DESCRIPTION OF WORK TO BE INSPECTED SU&ePz-� C_4,�� a-Irk9
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A field inspection was conducted to determine compliance with - approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:ten1p:b1dg:fomis:ocaprv1 3/25/04
Permit Inspection Details
Permit: BLD20060407
PERMIT'IRzA�
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0513112006 SMITH 45 APPROVED
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Total Time:
46
Total Inspections:
Total Time:
45
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing .................
Wall � .........................
Pier/Porch .................
Retaining Wall
Slab Insulation ..........
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PLUMBING:
0
Uncterground
Rough -in ...................
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Commercial Final
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HEATING:
0
0
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Gas Test ....................
-4
3: IT
Gas Piping ..........
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CEquipment
............
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Commercial Final
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EXTERIOR SHEATHING
NAILING ..........................
-4
FRAMING ........................
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0
rr;
FIRST FLOOR FRAMING
0
INSULATION ...............
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Floor Insulation
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Wall insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
-4
3:
(1)
SPECIAL INSPECTION
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MISCELLANEOUS ..........
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FINAL APPROVAL FOR
OCCUPANCY