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950185.pdfCITY OF EDMONDS USE PERMIT ZONE NUMBER sot CONSTRUCTION PERMIT APPLICATION ,Dd 999 SUITE APTD n WNI:HI tl_ NA1.11- 0IUI INFSS ADDRESS�- C� LEGAL DESCRIPTION CHECK SUBOIYIS ON 110 LID NCO LC.I i; MAILING ADOIJ' O Z �� •I `H! PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCPAPProvetl ❑ l:I v IP TELEPHONENUMBER nW PL-1 R,,,.-d ❑ �( "11 EXISTING__—REOUIIICD DEDICATION.__... _.. ... SirceI USe Perm�i Req'tl ❑ O4V ��QH Z `:CJ PgOPOSEO _ Insocctlon Requuctl ❑ NAME —"-----'--"" Sld—lk Roqu-d ❑ METER SI7.E LINE SIZE NO Di fl%TUBES PRV REOUIREO w ADDRESS YES ❑ NO ❑ U t REMARKS _ a CITY ZIP TELEPHONE NUMBER Z Z NAME AD1JRFKS O ENGINEERING MEMO DATED REVIEWED BY U �— a TELEPHONE NUM R lI{ FIRE MEMO DATED REVIEWED BY O S E l.I (:F NSI: NIIMItEn EXPeIIR�ATION DATE �ZV SIGN AREA SEPA REVIEW ADD NO Legal Description Of Propefty - include all eas ments ALLOWED PROPOSED COMPLETE JEXEMPT SHORELINEp O EXP VARIANCE OR Cu PLANNING REVIEW BY DATE U SETBACKS — FEET HEIGHT LOT COVERAGE FrgPedy FRONT SIDE REAR a T.TX AC—." REMARKS as rcel No Pa�wf Q RESIDENTIAL PLUMBING AUIIItJN COMMERCIAL Q NICAL d1D:MOOEI ❑ APT. SLOG. ❑ SIGN GRADING CYDS. � ENCE K—� CHECKED BY TYPE OF CONSTRUCTION CODE/ / CRCOUPANT dEVAIn `/J 3 DEMOLISH ❑ WOODSTOVE ❑ SWIM POOL SPECIAL INSPECTOR AREA OCCUPANT INSERT HOT TUB/SPA REQUIRED LOAD ❑GARAGE RETAINING WALL/ I] YES CARPORT ROCKERY RENEWAL REMARKS (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 305 ii U _ ,N NUMBER NUMBER OF CRITICAL OF DWELLING AREAS Q STORIES UNITS NUMBER -' DESCRIBE WORK TO BE DO (ATTACH PLOT P NI 1` FINAL INSPECTION REQUIRED I, VALUATION FEE 2-PLAN CHECK FEE �j HEAT SOURC GLAZING BUILDING `/� �� 0/0 PLUMBING �Jv Plait Check No. MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, Sldewe-lks, 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 m successors in interest, agrees to indemnify, defend and hold w harmless the City of Edmonds, Washington, its officials, s employees, and agents from any and all claims for damages of a 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 ° 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 comply with City and THIS PERMIT This application is not a permit until state laws regulating construction; and n d ing the work authoriz. AUTHORIZES ad thereby, no per w+,v' a employed I violation o1 the Labor ONLY THE signed by the Building Official or his/her Code of the S of W ngfOrr'ielating Workmen's Compensa- WORK NOTED Deputy; and lees are paid, and receipt is lion Insur ce and INSPECTION acknowledged in space provided. SIGNAT EIOWNER ) re02SIGN ND� DEPARTMENT CITY OF OFFIGIA S SIG NATUR� DATE i EDMONDS ATTENTION CALL FOR RELEASED BY INSPECTION DATE IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE _0ION UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 7 INSPECTION l LL ORIGINAL — File YELLOW —Inspector / A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. PINK — Ov:.ner GOLD — Assessor 1028r I I 1 i. I 11111111111 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ................... FOUNDATION: Footing .................... Wall ....................... Pier/Porch................ Retaining Wall............ Slab Insulation ............ PLUMBING: Underground ............. Rough -In ....... I......... Commercial Final ........ HEATING: Gas Test ................. Gas Piping ................ Equipment ................ Commercial Final......... EXTERIOR SHEATHING NAILING .................... FRAMING .................... INSULATION: Floorinsulation .......... Wall Insulation ........... Ceiling Insulation......... SHEETROCK NAILING ...... SPECIAL INSPECTION ...... RADON MONITOR AT SITE. FINAL APPROVAL FOR OCCUPANCY.........: