20060414.pdfIIII 1ICEI1ID
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
PERMIT
NUMBER
JOB
ADDRESS
PLAT NANIE/SUSDIVISION NO, LOT NO, LID NS
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP I—P
EXISTING PROPOSED
REQUIRED DEDICA1 ION __ IT
METER SIZE I LINE Sl� �NOOF FI-TLRES Y,P VAEOUIRED
SO NO 13
REMARKS
OWNERICONTHACTOR RESPONSIBLE FOR EROSION CONTROUDSAINAGE
PROP
EQ`1'
113 Y`EE 3
NO
NEW F1 RESIDENTIAL
13 WAIVER
ZONE
I ALL SIGN AREA
FBI_ —'I
AL
COMMERCIAL
ADDITION COMPLIANCE OR
CHANGE OF USE
"BE
E3 STUDY
LOT COVERAGE
ALLOWED PROPOSED
REQUIR D SETBACKS RFT,
FRONT 1111 REAR PRO
FRONT
POSED SETBACKS r:
URSIDE REA
. FAMILY SIGN
r REMODEL 'E�I�XLETD,
I
REPAIS -'o RADIN. E] FENCE X
CYDS FT.)
PARKING DED
Plan PROV,
LOTAREA
PLANNING REVIEWED By DATE
DEMOLISH TANK OTHER
I
REMARKS
ETAI ING .2 SPRINKLER
m GARAGE R N WALL F
ARPORT ROOKERY REAA�RM
7TYPE —07 USE. SUZMZa�ILMM
NUMBER
OF
c STO IES
ER OF
No
,JNSTRUCTION
OCCUPANT
Up
GROUP
DESCRIBE WORK TO HE DUPI
SPECIAL INSPECTION
REQUIRED E3 YES
ON�U�LTA�T
&VANT
L B
REMARKS
J�
BY
$VALUATION
Description FEE Description FEE
HEAT SOURCE LOT SLOPE% Plan Check State Surcharge
VESTED DATE i
PLAN CHECK NO: Building Permit City Surcharge
ev, 'Plumbing _�as, Fee . gL9
THI PERMITAUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
TY LYANY CONSTRUCTION ON THE PUBLIC Mechanical
BE ONE ON PRIVATE PROPER ON
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC�j WILL REQUIRE
SEPARATE PERMISSION.
Grading
PERMIT APPLICATION: SEE ECDC HLOOkOSAI(S)
Engr. Review
Recording Fee
PERMIT LIMIT'. SEE ECDC 19.00,005(A)(6)
Engr, Inspection
Plan Chk. D.positj
SEE BACK OF PINK PERMIT FOR MOR INFORMATION
ON BEHALF 0 HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSOR
Fire Review
Receipt #
;APPLICANT,
N INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS , WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Total Amt. Due
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF T IS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Receipt If
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
1_8nd,capelrlp,
APPLICATION APPROVAL
IHERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION[i THAT THE INFORMATION
AND THAT I AM THE OWNEA� OR THE DULY AUTHORtZ 0 AGENT OF
CALL
P-1-11 -01 ��gr-V
GIVEN IS CORRECT.
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
FOR INSPECTION
,, Olj�I .1 D�PLIY — I— —
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
WORKMEN'S COMPENSATI��SURANCE AND RCW 18;2!�
(425)
771 -0220
e,pl 11 alkno-dge— $PIC, P1d1d
OFFICIALS SiGNATUREL 5/-� DATE
7—�Unw
ATUR�
A
Y
��NEROG
7
EXT. 1333
I - T . IS UNLAWFUL TO USE OR OCCUFiY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL , FILE YELLOW - INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 I IRC110- PINK . OWNER GOLD - ASSESSOR
6/05 PRESS HARD - YOU ARE MAKING 4 COPIES
r
z
0
0
C m
ma
-4 0
0 0
X m
M Z
o'n
n
m M
a
0
0 M
C CA
U)
M
Z
7-1
10
I
z
-4
x
65 1
z
9
0
m
1�, 11111
Permit Inspection Details
Permit: BLD20060414
PERMITTRAX
'M'T�
............
01123/2007 SNOOK 20 APPROVED
y
Total Time: 20
Total inspections:
1 Total Time: 20
z
MO
X
M
C
M
0
0
M
M z
U
C
C
0 3
M M
C)
0
C
M C)
z
;u
>
z
z
M
J
V,
61912009 1:34:17 PM
Page I of I
r
RECORD OF INSPECTICINS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall ............
Pier/Porch .................
Retaining Wall . ..........
Slab Insulation
PLUMBING:
Underground .............
Rough -in .............
Commercial Final
HEATING:
GasTest ....................
Gas Piping ..............
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING .....................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION .. .................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION