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CITY OF EDMONDS ZONE , PERMIT Q�y.•
CONSTRUCTION PERMIT APPLICATION NUMBER
JOB r SUITE/APT
M
OWNER NAME NAME OF BUSINESS
ADDRESS '"]
khomvv -'1 �li�/ LEGAL DESCRIPTION CHECKr
SUB D ISIO NO LID NO
MAILING ADDRE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved
CITv ZIP TELEPHONE NUMBER RW PermRequired ❑
"�� EXISTING REQUIRED DEDICATION Street Use Permit Req'd O
ULDf L'�
Inspection Required ❑ NA PROPOSED Sidewalk Required ❑
1 "C�■ •- �R/�j \ METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
ADDRESS J {, 11 YES ❑ NO ❑ 3
REMARKS Z
CITY t . ' ZIPJ TELEPHONE NUMBER �/fs� u� 4",OrX wwr'+.&*. s A*W Aay�
N
ADDRESS P*4
ENGINEERING MEMO DATEREVIEWED BY
CITY ZIP TELEPHONE NUMBER
FIRE MEMO DATED REVIEWED BY
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STATE LICENSE NUMBER EXPIRATION DATE LL
R� ROt- — S SIGN AREA SEPA REVIEW AD O
Legal
Description of Property - include all easements h� •pY�• ALLOWED 1 PROPOSED COMPLETE EXEMPy
.7 VVEN
EXP
VARIANCEVARIANCEA UU L ING NQEW BY DA E
SETBACKS FE T HEIGHT LOT CgIVER Z
a/ z
Property 1r� cT FRONT SIDE REA / _
Tar Account e� I lr o f J 1 I1 REMARKS a
Parcel No. / 1 U
NEW RESIDENTIAL 0 PLUMBING /
ADDITION COMMERCIAL El MECHANICAL t "—
REMODEL APT. BLDG. El SIGN
Feel GRADING FENCE CHECKED BY TYPE OF CONSTRUCTION CODE OCCUPyr'T
REPAIRCYDS ( x_FT) �- / �} ` GROUPr �{
DEMOLISH WOOOSTOVE SWIM POOL ! / `41
INSERT HOT TUB/SPA SPECIAL INSPECTOR AREA OCCUPANT
GARAGE a RETAINING WALL/ REQUIRED ❑ YES LOAD
CtiRf9lTt ROCKERY RENEWAL REMARKS
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YPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER USC 305 s
SOLJ
NUMBER co
NUMBER OF CRITICAL
OF DWELLING AREAS �
STORIES UNITS [NUMBERJ#�//
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
? 1' FINAL INSPECTION REQUIRED
VALUATION FEE
PLAN CHECK FEE
HEAT SOURCEGLAZING BUILDING
I AM
PLUMBING
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 sO
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
tn successors in interest, agrees to indemnify, defend and hold
WLn harmless the City of Edmonds, Washington, its officials,
m employees, and agents from any and all claims for damages of
i whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT -.--�
modify, waive or reduce any requirement of any city ordinance
o nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE --
provision."
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 authorize 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. INSPECTION acknowledged in space provided.
SIGNATURE IOvvNER Og AGE TI DATE SIGNED DEPARTMENT
a �� ' CITY OF O F CIAL $ IGNATURE DATE
EDMONDS A64t
AOTENTION INSPECTION
CALL FOR ELEAS B DATE
�) .„2 c
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE ��� ®���
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — Flle YELLO — nspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3. PINK — Owner GOLD — Assessor
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS..... oli, (e ��
FOUNDATION:
Footing ... ..•..••,1........
Wall...
Pier/Porch ................
Retaining Wall. ••. do. 1..1.
Slab Insulation ............
PLUMBING:
Underground .............
Rough -In .................
Commercial Final . •... ...
HEATING:
Gas Test .................
Gas Piping.,: �....;..:.
Equipment..; . 1. do 0. 111.11
Commercial Final.........
EXTERIOR SHEATHING
NAILING ....................
FRAMING .. '
INSULATION:
Floor Insulation...........
Wall Insulation .• do. ••.111 —
Ceilirig'Insulation........ .
SHEETROCK NAILING ......
SPECIAL INSPECTION ......
RADON MONITOR ATSITE .
FINAL APPROVAL ' �. 6
FOR OCCUPANCY ....... • • . doodooddo
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