970942.pdfUSE PERMIT ID'�
CITY OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICATIONJ06S �J c
OWNER NAME;NAME OF BUSINESS ADDRESS L _nL
STATE LICENSE NUMBER
/0/ i
L
LEGAL DESCRIPTION CHECK
SUBDIVISIO 0
LID NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING REQUIRED DEDICATION
PROPOSED
TESCP Approved
RW Prold RK-ed
Street Use Per-1 Reo'd
Inspection Reeooed
SIdewtlk Rapwred
❑
❑
❑
❑
❑
METER SIZE
LINE SIZE
NO OF FIXTURES
PRV REQUIRED
YES ❑ NO ❑
REMARKS
ENGINEERING MEMO DATED
REVIEWED BY
FIRE MEMO DATED
Y
REVIEWED BY
SERA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
EXP
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED I PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR ,-
,
J Tat ACCC. nI / v� / /
LOT AREA
PLANNING REVIEW BY
DATE
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Parcel No. ( i
�LUMBING/MECH
REMARKS
NEW
SIDENTIAL
_
ADDITION
COMMERCIAL
CHANGE OF USE
ElREMODEL
APT.BLDG.
SIGN
Q GRADING ❑ 1 ENCE
CHECKED BY TYPE OF CONSTRUCTION CODE
GRCCUP NT
REPAIR CYOS K-�
J
DEMOLISH F-1 WO INSERT DTOVE SWIM POOL HOT
SPECIAL INSPECTOR
V
AREA
OCCUPANT
UB SPA
REQUIRED
AYES
LOAD
GARAGE ❑ RETAINING WALL/ ❑
❑
CARPORT ROCKERY RENEWAL
MARKS
a ITYPEOF USE. BUSINESS OR ACTIVITY) EXPLAIN:
PROGRESS INSPECTIONS PER UBC 108
2
0
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NUMBER ,1
NUMBER OF
CRITICAL
H S /
�%'�
o OF
DWELLING
AREAS
STORIES Vim+
UNITS
NUMBER
D CRIBE WORK TO BE DONE (ATTACHPLOT PLAN)
�! G /007
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FINAL INSPECTION
REOUIRED
?
VALUATION
FEE
PLAN CHECK FEE
HEAT GLAZING
BUILDING
/SOURCE',
/'.
D/a
PLUMBING
L,
Plan Check No.
MECHANICAL
571
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any const ruction on the public domain (curbs, sidewPlks,
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
"Applicanl, on behalf of his or her spouse, heirs, assigns and
ENO. INSPECTION FEE
w successors in interest, agrees to indemnify, defend antl 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
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
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provision."
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly
ATTENTION
APPLICATION APPROVAL
authorized agent Of the owner. I agree to comply with city and
THIS PERMIT
slate laws reguiat ing construction; and in doing the work authoriz•
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 o1 Washington relating to Workmen's Compensa.
WORK NOTED
Deputy; and fees are paid, and receipt is
Lion insurance and RCW 18.27.
INSPECTION
acknowledged in space provided.
AGENTI DATE SIGNED
DEPARTMENTCITY
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Lil"
DF
OFFICI 'S SIGNATUREDATE
-
EDMONDS
6•
CALL FOR
RELEASED D ATE
ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771 - 0220
ORIGINAL - File YELLOW - Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
/.
SECTION 109
PINK - 0'.--.- GOLD - Assessor I SI
10287
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RECORD OF INSPECTIONS
INSPECTOR - DATE APPROVED
.. _ SETBACKS...... ............. ..
- FOUNDATION:
Fooling ................... _..,
.Wall..
Pier/Porch,l....;......... '
Retaining Wa1L:.........
Slab Insulation............ -'
. .. ' PLUMBING:
Underground ............. - ..
Rough in ................. - •:
-
Commercial Final........
HEATING:
..GasTest................. ;�..
.
` Gas Piping....•...........
-
- ..... .. Equipment ...............
. - Commercial Final.........
EXTERIOR SHEATHING - - -
NAILING .................... ..' ....
e
FRAMING ...................
_.. INSULATION: ., , ...
.. .:. Floor Insulation............. ..�. _
...
Wall Insulation ...........
... Ceiling Insulation.........
SHEETROCKNAILING .......
SPECIAL INSPECTION...... -- -
e
-
MISCELLANEOUS
-:.
FINAL APPROVAL `mot ramzz
FOROCCUPANCY..........
.._ 777 _
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