940295.pdfr.
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CITY OF EDMONDS ZONE PERMIT 9410;9S
CONSTRUCTION PERMIT APPLICATION ,QB NUMBER SUITE APT u
OWNER NAME NAME OF BUSINESS //-,, ADDRESS ? L �afe n
cc L 4r G6 r7AOWt LEGAL DESCRIPTION CHECKK SUBDIVISION NO LID NO
w MAILING ADDRESS
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O Z • ��J• �4 G�'� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
CITY ZIP TELEPHONE NUMBER RWPer Approved ❑
Permit Required ❑
f EXISTING REOUIREO DEDICATION ___ Street Use PermitReq'd ❑
gewo / PROPOSED Inspection Required ❑
NAME — — Sidewalk Required ❑
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METER SIZE LINE SIZE NO OF FIXTURES PRV REQUIRED
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ADDRESS YES ❑ NO ❑ 3
S REMARKS Z
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Cc CITY ZIP TELEPHONE NUMBER w
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NAMEw
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ADDRESS
U �7D 4� /�/`+ // ✓ �} ENGINEERING MEMO GATED REVIEWED BY
cc CITY (/ ZIP TELEPHONE NUMBER
Z /J FIRE MEMO DATED
O 2�Z-- U (J REVIEWED BY w
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STATE LICENSE NUMBER EXPIRA ION DATE LL
���/•�-� /Oi�� lZ�CfL/ SIGN AREA SEPAREVIEW I ADB NO
Legal Description of Property - include all easeme is ALLOWED PROPOSED COMPLETE rEXEA+PT
Z SHORELINE#
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U VARIANCE OR CU PLANNING REVIEW BY DATE
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a SETBACKS — FEET HEIGHT LOT COVERAGE Z
u' Property FRONT SIDE REAR =
Tax Account l�3�� poo p ?�/o / REMARKS 5
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Parcel No. 1r�•�I
NEW {,Ll. RESIDENTIAL D PLUMBING
ADDITION 1:1COMMERCIAL� MECHANICAL
CIREMODEL 1:1APT. BLDG. El SIGN
GRADING FENCE CHECKED BY TYPE OF CONSTRUCTION ICODE OCCUPANT
REPAIR 1:1CYOS GRO 3
( x _FT)
DEMOLISH 1:1WOODSTOVE 1:1SWIM POOL SPEC!AL INSPECTOR AREA OCCUPANT
INSERT HOT TUB/SPA REQUIRED LOAD
GARAGE RETAINING WALL/ O YES
CARPORT El ROCKERY 1:1RENEWAL REMARKS
a(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 305 0
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w NUMBER NUMBER OF CRITICAL
o OF DWELLING AREAS
to STORIES I UNITS NUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLO PLAN)
10IS7114 L 6 R ��rvyL FINAL INSPECTION REQUIRED
All.,/7 ,/ PPZVK 7 /�AJ !/5 t A� �� VALUATION FEE
PLAN CHECK FEE /^
HEAT SOURCE GLAZING oI0 BUILDING /
PLUMBING 67
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Plan Check No. MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE
N successors in interest, agrees to indemnify, defend and hold
w harmless the City of Edmonds, Washington, its officials, Cam/
f employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance PLAN CHECK DEPOSIT
T of this permit. Issuance of this permit shall not be deemed to
o modify, waive or reduce any requirement of any city ordinance
= nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
provision." j
I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL
information given is correct: and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and THIS PERMIT
state laws regulating construction; and in doing the work authoriz• AUTHORIZES This application is not a permit until
ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa• WORK NOTED Deputy: and fees are paid, and receipt is
tion Insurance and RCW 18.27. INSPECTIcP, acknowledged in space provided.
SIG I V:N R OR AGENT DATE SIGNED DEPARTME'.T
CITY OF OFFI , S ti TURE OArG
G ?6 gL EDMONDS
CALL FOR RELEASED DY DATE
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE �� J _ 02�0
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR "� ORIGINAL — Flie YELLOW — Inspector
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CHAPTER
3.
102.87
PINK — O.•.'e' GOLD — Assessor ;; c
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS, . ....
FOUNDATION:
Footing, .
Wall .......................
Pier/Porch ................
Retaining Wall............
Slab Insulation............
PLUMBING:
Underground. .
Rough -In .................
Commercial Final.
HEATING:
Gas Test.. , J7157 ��� rIQ—
Gas Piping ............... .
Equipment ............... .
Commercial Final, ........
EXTERIOR SHEATHING
NAILING ....................
FRAMING ....................
INSULATION:
Floor Insulation ..........
Wall Insulation ...........
Ceiling Insulation.........
SHEETROCK NAILING ......
SPECIAL INSPECTION ......
RADON MONITOR ATSITE.
FINAL APPROVAL--
.3�2�
FOR OCCUPANCY. ,
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