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960487.pdfC CITY OF EDMONDS USE zD"E PERMIT NUMBER g 609'g7 CONSTRUCTION PERMIT APPLICATION t 1'.\NLlr N.AML \ill['{�`1{r/�RLI,I."NESS �oB ADDRESS /^ �r � ( 1 Iu //''�� fc �f- ' ] 41AILING •IODRESS OIvmac UT CITY ZIP ITELEPHONE NUMBER NAME G roQn,—o-C 1 lf��•%inq t-Ate ADDRESS 11 bso fSICAJ2zJ A 0- P I E- _ ER C'k r k lamed �j$03� T$ C.3 N``nj LI STATE. LICENSE NUMBER E%PIRATIC ra erly Car Account Account �' 3 001 o 06 arcel No. NEW V TIAL PLUMBING ElADDITIONCIAL LEO]API MECHANICAL 11 G. II�" El REMODEL SIGN ❑ GRADING FENCE REPAIR CYDS (_x-_F DEhIOLISH ❑ INSERT TOVE ❑ HOT TUB SPA ❑CART OAT ROCKERVG WALL/ ❑ RENEWAL NUMBER (NUMBER OF C1F DWELLING Sr GIVI ES UNITS DESCRIBE WORK TO BE DONE IATTACF LEGAL DESCRIPTION CHECK SUBDIVISION NO 1UNO PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP jTES.PA,p.,f EXISTING._—__�_ REOUIRED DEDICATION.___ -.—.street PROPOSED-------'-Side-11, ❑ RW Permd Required ❑ Use Pwmd Rep d ❑.P.0101 Required ❑ Requred ❑ t ME TERSIZE LINESIZE NO OF FI%TUfiES PRV REQUIRED YES ❑ NO ❑ REMARKS ENGINEERING MEMO DATEDREVIEWED BY FIRE MEMO DATED REVIEWED BY SIGN AREA ALLOWED PROPOSED SEPA REVIEW COMPLETE JEIEMPT E%P ADB NO SHORELINE e VARIANCE OR CU PLANNING REVIEW BY DATE SETBACKS —FEET FRONT SIDE REAR I HEIGHT LOT COVERAGE REMARKS CHECKED BY t TYPE OF CONSTRUCTION CODF,.�� zu CK l OCCUP NT GRO SPECIAL INSPECTOfl REOUIRED ❑ YES AREA OCCUPANT LOAD REMARKS PROGRESS INSPECTIONS F" 'IBC 305 FINAL INSPECTION REQUIRED /7 i h . _I,, t� * over I PLAN CHECK FEE rI[AT SOURCE GLA.'.ING BUILDING O V/0 PLUMBING Plan Check No. MECHANICAL .S t This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewalks, driveways. marquees, e1C.) 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 successors ininterest. agrees t0 indemnity, defend and hold w harmless the City of Edmonds, Washington. its officials, a employees, and agents from any and all claims for damages of WITatever nature, arising directly or indirectly from the issuance T of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT omodify. waive or reduce any requirement of any city ordinance T nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE / y, �V' r GI', provision." I hereby acknowledge that 1 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 This application is not a permit until slate laws regulating construction; and indoing the work authoriz• AUTHORIZES THE signed by the Building Official or his/her ea thereby, no person will be employed in violation of the Labor CoGe of the Slate of Washington relating to Workmen's Compensa. ONLY WORK NOTED Deputy; and fees are paid, and receipt is Iron Insurance and RCW 27 INSPECTION acknowledged in space provided. • i[ C: E1 :` A vii: DArF. SIGNED V DEPARTMENT CITY OF OFF NATUPE D E EDMONDS CALL FOR LEASED DATE ATTENTION INSPECTION 17 IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ,v/, Jj 771 __w2o ORIGINAL — File YELLOW — Inspacl0r A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3 107IU I%e 7 / �C.•�' G (� PINK — Ov.rer GOLD — Assessor vp\ 0 -...,r..rwewwwawe.e..H so l 2X 16['_ 0 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ................... FOUNDATION: Footing.................... f Well ....................... 7- Pier/Porch................ Retaining Wall............ Slabinsulation............ - PLUMBING: Underground ............. Rough -In ................. 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........ 1. e o • 0 32XIC