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960699.pdfrom CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION lIIVLILR NAM' VAMF�I!tiIN[SS ,Oc- 9CiC,7Z TY ZIP TELEPHONE NUMBER �i.I�1,LICYG� �7G-s 77S—IS�tI R c'.- d��y�/sL'Frl Ss ziP TELEPHONE NUMBER J-'7e I ICENSE NUMBER EXPIRATION DATE �2 �1 ►o�c.� 7-I-97 Description of Property - Include all easements Q-K TaF N. Account /j; C/� o Parcel �j((UU/nni " N"V I.�.� RESIDENTIAL PLUMBINGfMECH DO PLIANCE OR ADDITION COMMERCIAL CHANGE OF USE RE MOnEL APT HLDG SIGN REPAIR GRADING Gros (ENCE X_FT EMOL,SII ❑ INSERT OVE ❑ HOT TUBS INSERT HOT POOL A GARAGE r--j CARPORT ROCKIERYG WALL/ ❑ RENEWAL TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: �•y� NUMBER NUMBER OP CRITICAL �Tl1OF CRITICAL 1'4T OF DWELLING AREAS ..I��•/ �k STORIES UNITS NUMBERSTv�r DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) H PERMIT 9 NUMBER6a699 GI%GSUITE All e vs LEGAL DESCRIPTION CHECK SUBDIVISION NO LID e NO PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP RW Ek1STING _—_ RECURRED OEDICATION S,RR, PROPOSED _ Inspection SdewAlk APPoved ❑ Poo R.Q11-d ❑ Use Perm11 Reed ❑ Requited ❑ RRvoed ❑ MCTE1512E LINE SIZE 1 NO OFFIXTURES 1 1111 nEO111RED YES ❑ NO ❑ RCMARK / ��X C b7e �S Side 14ur7L 1AIWd ENGINEERING MEMO DATED REVIEWED BY FIRE MEMO DATED REVIEWED BY SIGN AREA ALLOWED PROPOSED SEPAREVIEW COMPLETE JEXIMIT EXP ADB NO SHORELINEF VARIANCE OR CU PLANNING REVIEW BY DATE SETBACKS — FEET FRONT SIDE REAR HEIGHT I LOT COVERAGE REMARKS CHECKED BY TYPE OF CONSTRUCTION !/O'/L(�J M,g I CODE �4 OCCUPANT GROUP SPECIAL INSPECTOR AREA ].T REQUIRED AYES /7100 OCCUPANT LOAD REMARKS PROGRESS PROGRESS INSPECTIONS PER UBC 108 Oryr✓�r ies p,✓si� r�iL �s,�s7�r FINAL INSPECTION REOUIRED C- T-, f4 �/I n '-! VALUATION e PLAN CHECK FEE BUILDING roo HEAT SOURCE GLAZING a/0 PLUMBING Plait Check NO. MECHANICAL This Permit covers work to be done on private property ONLY. cRAInNG1FaL Any construction on the public domain (curbs, sidewel ks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Perrnit Application: 180 Days Permll 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 -- o successors in interest, agrees 10 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 whatever nature, arising directly or indirectly from the issuance T of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT oD' modify, waive or reduce any requirement of any city ordinance nor limit in any way the City's ability to enforce any or, TOTAL AMOUNT DUE provision V/D—• 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 This application is not a permit until st ate laws regulating construction; and in doing the work authoriz- AUTHDRIzss ONLY THE signed by the Building Official or his/her ed thereby, no person will be employed in violation of the Labor Code of the S to Of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and lees are paid, and receipt is t ion Insur and RCW 18.27, INSPECTION acknowledged in space provided. SIGNATU AGENT, DATE SIGNED DEPARTMENT CITY OF EDMONDS OFF) $ SIGNATURE / n DATE /� 10/1iV CALL FOR EA BY DATE 7ENTION INSPECTIIIO��NNf —�— IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR �� OLGO ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 10797 PINK — Owner GOLD — Assessor \ O f'1 erBl�®� . - _. -:^: �.-�::*.�n+.:� ..7j:X,-,:�...r.t .,:-,e .�.-.. .;,. :. .,....av yc •.v-'�'t1.,.... a. •m .,.a.... r .. ,. - .j ! � r : i Z 0 RECORD OF INSPECTIONS _ INSPECTOR DATE APPROVED--' SETBACKS ..................... _ FOUNDATION: Footing.................... Well....................... Pier/Porch................ RetalningWall............ Slab Insulation.....,...... PLUMBING: • Underground ............. Rough -In ................. Commercial Final ........ HEATING: Gas Test ................. Gas Piping ................ Equipment................ CommercialFinal ......... EXTERIOR SHEATHING NAILING .................... FRAMING .................... INSULATION: Floor Insulation........... Wall Insulation ........... - Ceiling Insulation......... SHEETROCK NAILING ...... SPECIAL INSPECTION ...... RADON MONITOR AT SITE. FINAL APPROVAL FOR OCCUPANCY.......... 7, /S1,96-7_ZaA/.s C V-4-,4) mid, .a7190- ��✓. ?��-s i 1. e 32Xat�..