950400 (2).pdfM
ZONE PERMIT
CITY OF EDMONDS :51,Z NUMBER 3-5n Ono
CONSTRUCTION PERMIT APPLICATION JOB LI) /// �p
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1SRESIDENTIAL
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SWIM POOL
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INSERT
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GARAGE
CARPORT
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❑ RENEW9E.
NUNniEn NUMBER OF ^, CRITIC
OF DWELLING I AREAS
STORIES O/ (� UNITS NUMB(
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLANE
LEGAL DESCRIPTION CHECK
SUDDIV-0N ND
110 NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
E rISTING ...- __._. _ REQUIRED DEDICATION ... _........_.
PROPOSED .--'-- ----------_
TF.SCP Approved ❑
RW Pe—n Realnred ❑
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s,eewalA Red,I,len ❑
MEIER SIZE
LINT: SIZE
NO Oi it%TDEIER
Pnv REQUIRED
ES ❑ NO ❑
REMARKS
ENGINEERING MEMO DATED REVIEWED BY
FIRE MEMO DATED REVIEWED BY
SIGN AREA
ALLOWED PROPOSED
SEPA REVIEW
COMPLETE EX
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ILOT CO /ERAGE
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REMARKS
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TYPE OF C STRUCTION CODE
OCCUPANT
GRO
SPECIAL INSPECTOR AREA
REQUIRED
❑ YES
OCCUPANT
LOAD
EMARKS
PROGRESS INSPECTIONS PER UBC 305
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FINAL INSPECTION REQUIRED
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PLAN CHECK FEE
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PLUMBING
Plan Check No. 9s-�Zlyt
MECHANICAL
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This Permit covers work to be done on private properly ONLY.
GRADINGIFILL
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Any construction on the public domain (curbs, sidewalks,
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driveways, marquees, etc.) will require separate perm lesion.
STATE SURCHARGE
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Permit Application: 180 Days
STORM DRAINAGE FEE
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
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m successors in interest, agrees to indemnify, defend and hold
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`.,', harmless the City of Edmonds, Washington, its officials,
employees. and agents from any and ail claims for damages of
whatever nature, arising directly or indirectly from the issuance
PLAN CHECK DEPOSIT
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T of this permit. Issuance of this permit shall not be deemed to
omodify, waive or reduce any requirement of any city ordinance
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= nor limit in any way the Cily's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
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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
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authorized agent of the owner. I agree to comply with city and
THIS PERMIT
This application is not a permit until
slate laws regulating construction; and In doing the work authorii•
AurHORlzes
THE
signed by the Building Official or his/her
ed thd in violation of the Labor
ereby, no person will be employe
ONLY
WORK NOTED
Deputy; and fees are paid, and receipt is
Code of the State of Washington relating to Workmen's Compensa.
acknowledged in space provided.
lion Insurance and RCW 18,27.
INSPECTION
sIGNAT RE 191—ER OR AGENT, DATE SI EO
DEPARTMENT
F GNATURE —DATE
CITY OF
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7�r�&-ys
EDMONDS
CALL FOR
R ° DATE
ATTENTION
INSPECTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
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UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771 - 0220
ORIGII• AL — F-le YELLOW —Inspector
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A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
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CHAPTER 3.
Ipaer
PINK — Oxner GOLD — Assessor
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1i TERM
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...................
FOUNDATION:
Footing ....................
Wall .......................
PiedPorch................
Retaining Wall............
Slab Insulation............
PLUMBING:
Underground ..........f.
,
Rough -In .................
Commercial Final ........
HEATING:
Gas Test .................
Gas Piping ................
.. ,. � Equipment..:._..,:........
Commercial Final.........
EXTERIOR SHEATHING
NAILING ....................
FRAMING' ................
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INSULATION:
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Floor Insulation..........
Wall Insulation...........
Ceiling Insulation.........
SHEETROCK NAILING ....��
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SPECIAL INSPECTION ......
RADON MONITOR AT SITE.
FINAL APPROVAL
FOR OCCUPANCY.....
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