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usE PERMIT '
CITY OF EDMONDS ZONE �5-:� )12NUMBER
CONSTRUCTION PERMIT APPLICATION
OWNER NAMCINeME . / ADDRESS —
�' CA `c,a �Ye L-L
e'C.'l 7 >
4 w MAILING ADDRESS
elf .I gL6ol� T�"�♦♦'D LE' 4 9
NAME
NAME
1 t k�
STATESIOENSEr1T1-MBER
LEGAL DESCRIPTION CHECn
SUBDIVISION No
LID NO
16
S- O_X.
PUBLIC RIGHT OO.F, WAY PER OFFICIAL STREET MAP.
TESCP Approved ❑
OEUICATION
RW PBrmlI ReRPired $
E%IS;!N6lfe_—REOUIREU
PPOPDSEO ��/�1
SUaet Ufe Permit neutl ,O.
1^�PeC11oA RapUirad/]�LTH�
Sidewalk Repaired
METE`SRE
LINE/SI2E
NO. OF FI UREB
PRV REQUIRED
33
3
EB NO ❑
REMARKS ^iNS'L. Y4,.,
Gi I/�Ur �G1b✓ L en I.,
ulA. Spa we, fv rX. R/ --k
ENGIN ERING. E_ DATED
REVIEWERBY
( 2 7 '9'�
T
FIRE MEMO GATED
REVIEW.. a'
L gal ID e n tion or Prop y - Include all --same s
'SEP REVIEW
COM EXEMPT
�H IG
U,
a
SIGN
'ALLOWED
AREA
PROPOSED
—
HEIGHT
ALLOWED
3o'r
PROPOSED
2'
IS
-
17
ALLOWED OV PROPOSED
A
RE FRONT SIDEREARCKS )
zs'
PLANNING REVIEW BY
`v
PROPOSED
ESETBACKS UR SIDEREAR
DATE
Ij
19n.
propedy ,- .. n^.�..,' LOTAREA
TorNo.. o�I 'O'ul �000(N�a .Z s
Perrot
NEW
RESIDENTIAL
�i Pl. DMBING'MECH'
COMPLUNCE OR
Cm[ d'n4 1
N
-
Li ADDITION COMMERCIAL a CHANGEOFUSE
"'
APT. SLOG.
,r .S7Vi[`l
ci 6E[.SaD OSi[aI O.
REMODEL }'
O�R�AOcIN�D
CHECKED BY TYPE OF CONSTRUCTION COG / OCCUP T{T
GROU p1(�
El flEPAIR 1-A��-CYOS. ( - _Fh
W-,.+ J(/
_"(
r>v `%
-
DEMOLISH NBERT TOVE Q HOIM POOL
SPA
ECTOR AR� / 'Y_ OOAOPANT
RPECIAIO
YES
� 63 -5-1136
GARAGE ;� RETAINING WALL/
® CARPORT'-' ROCKERY � � RENEWAL_
MARKS ''.
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-
(TYPE OFU U$INTS OR ACTIVITY) EXPLAIN. -
R
PROGRESS INSPECTIONS PER UBC t08
_
Y I6
�� /l• L6dLSFoT[
HUMS y' NUMBER OF t CRITICAL
AREAS
/ l&W_ UNITS �/��.. NUMBER 6-ZZ�
7,i !
Sons .4 rey�i4[�X K, QO llSf �E #I LZSog
STORIES
EWORK TO BE O EIATT CH PLOT PLANT
_
i
FINAL INSPECTION
REQUIRED
,k7_ O l • ^j Dv
VALUATION - FEE
PLAN CHECK FEE
/]8(�6Q7
..//!!
/A rim•.[ .� /.��i'.J/%
eUILDINO
/9 5 2 06 7—
-.
HEAT$O CE: GLAZING
PLUMBING
Plan Check No. ..
MECHANICAL
13d
This Permit covers work to be done on private property ONLY.
GRADNGIFILL
15740
Agy4onstrucUon on the public domain (curbs, sIA9wolks,
q,s0
driveways, marquees, etc,) will require separate pg I9slon.
STATE SURCHARGE
Permit Application: 180 Days y",
STORM DRAINAGE FEE
Permit Limit: I Year. Provided Work is Started Within 180 Days
_
�gr�pduse, heirs, assigns and
on behalf of WIN
EN ., PECTION FEE
//.. --
w
'successors in Interest, a0� ,%i dp.Tify, delentl end hold
Successors
City of Edmonds, Washington, its oiflcials,
w
f
harmless the
andagents from any and all claims for domege9"df`
0 SS/0!•'A�
1f 7 CS
employees,
whatever nature, arising directly or Indirectly from the Issuance
PUN CHECK DEPOSIT
- s
of this permit. Issuance of this permit shell not be deemed to
r' '
�O R
omodify, waive or.retlLice any requirement of any city ordinance ,
nor Ilmit In any way the City's ability to enforce any ordinance TOTAL -AMOUNT DUE
provision."
1 hereby acknowledge that I heve read thls application; that the
gTYENTION,
APPLICATION APPROVAL.
Information given Is correcC and that I am the owner, or the duly
('i
authorized agent of the owner. 1 agree to comply With city and
.,.',•I THIS PERMIT
This application is not a permit until
state laws regulating construction; and In doing the work authorize'
."AUTHORIZES
signed by the Builtlin OHic ai or his/her
ed thereby, no person will be employed in vlolallon'Iil the Labor.
WORK NOTED
Dputy: and fees are paid, and receipt Is
Code of (he State of Washington relating to Workmen's Compen$a
acknowledged In space provided.'
lion Ins rAnc an0 RC 7.
SIGN TU E I W R R GENJ OATE SIGNED
INSPECTION
DEPARTMENT
CITY OF
OF ICIAL'S SIGNATURE
—I
EDMONDS
L•f' 1�
-
CALL FOR
EL
ATTENTION
INSPECTIIO�N/]
IT IS UNLAWFUL TO USE OCCUPY A BUILDING OR STRUCTURE ��� a®LSO UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
ORIGINAL — FIle YELLO — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED: UBC
SECTION 109
10287
PINK —;Owner GOLD—.AssesSDr
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RECORD OF INSPECTIONS
RECORD OF INSPECTIONS
1 INSPECTOR
-.
DATE APPROVED
SETBACKS ..................
FOUNDATION:.
• Footing
,{
... Well ...
..
Pier/Porch " +a�•}: +.y,y,r. _..,;;}"
%: Ref@Ining Wall..
Slab Insulation .............
PLUMBING:
Underground.... ...... ✓. / '
!// I'
„-J
- Rough In .....
n ..
anL( 1
1
Cominerclel Final ....
HEATING:7.
g!Z(o /etQ C
Oae Tetat
r> Gas Piping
,.�'`• `.Commerrtiel Final. ..... f' _.,..
1 i
- EXTERIOR SHEATHING
t NAILING
x
\FRAMIN(i4
' t
... .:. INSULATION:
Floorinsuletlon...........
Well Insulation ...........
.`.. \:. Z .� `,, •.':.�..
'.,;Gelling inguletlon.........
\ SHEETROCKNAMING......
SPECIAL INSPECTION...... ----------------
MISCELLANEOUS -
�7
VAL
FINAL APPRON........ 1 riJ
F.ORP CCUPAcY:
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