980470 (2).pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLIC�
OWNVANAAIE+NAME OF BUSINESS
M
STATE
EXPIRATION DATE
r
USE PERMITC7�/14 -�
z0NE NUMBER �I n r
I I N CHf7A
77-51 H N0.
u0NO
T Or WAY PER OFFICIAL STREET MAP
TESCP APP10—
❑
___REOUI"EDnEpICAT10N__
RW Permit RFpuReO
Slreel Ufe PRepo
❑
❑
LINE SIZENO
OF FIXTURES
PRV REQUIRED
FE.A,�,4�,
YES ❑ NO ❑
S ; YI•�Y?,SJ
MEMO DATED
REVIEWED BY
FIR M MO DATED
REV( DBY
egal Description
of Property - include all easements
Ar.,„wyc
SEPA REVIEW
SIGN
AREA
HEIGHT
G r-
��
COMPLETE EXEMPT
ALLOWED
PROPOSED
ALLOWED PROPO:
r H II II
It
EXP
REQUIRED SETBACKS )FT.)
FRONT
R NTUIDE REAR
PROPOSED SETBACK;
FRONT - SIDE R
tjOT COVERAGE
ALLOWED PROPOSED
UP
'Ir Account
NDO
LOT AREA
INO REVIE Y
DAT
cal No. lJ LJ W r/ LN CO
REMARKS
Ell NEW -
RESIDENTIAL ,
�❑ PLUMBINGUMECH
IANCE OR
El
ADDITION
COMMERCIAL
CKANOE OF USE
REMODEL
APT' BLDG.
SIGN
yrtl
GRADING
FENCE
❑
CHECKED BY TYPE OF CO Tn1 CTION CCD
OCCUPAn
0
REPAIR
O CYpa.
(—.—FT)
DEMOLISH
WOOOSTOVE
INSERT
SWIM POOL
SPECIAL INSPECT OR
AEA
O DGPAN
HOTTUS/SPA
REQUIRED
YES
LOAD
-
GARAGE
CARPORT
RETAINING WALL/
" ROCKERY
RENEWAL
R MARKS
PROGRESS INSPECTIONS
PER USC
108
rYPEOF USE,BUSI Tm IXPLAIN:
VUMBER
I NUMBER OF
DWELLING
{
CRITICAL(/�[�.�
AREAS �/�In
r '
FINAL INSPECTION REQUIRED
1
lace e t/J., ,-Ic ecK
VALUATION
_//er
11
PLAN CHECK FEE
" 10
BUILDING
/
HEAT SOURCE:
GLAZINGe�
�%'(�//PLUMBINGPlan Check No. y7 7N —/ �MECHANICAL
IFEE
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewRlks,driVBWayS,
marquees,etc.) Will require separate Permission- �.
STATESURCHARGE
Pemdt Application: 180 Days
STORM DRAINAGE FEE
Permit Limit: I Year- Provided Work Is Started Within 160 Days
-Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
,n successors in Interest, agrees to indemnify, tlelentl and hold
W harmless the City of Edmonds, Washington, its officials,
1kST16 R'
r
�/'Ce
employees, antl agents from any and all claims for damages of
< whatever nature, arising directly permit Indirectly Irom the Issuance
z of this permit. Issuance of this permit shell not be deemed to
PLAN CHECK DEPOSIT
omodify, waive or reduce any requirement of any city ordinance
s nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
i
S> lei
provision."
I hereby acknowledge that I have read this appilcatlon; that the
ATTENTION
APPLICATION APPROVAL
ntormatlon given Is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and
Ing and In doing the work aLlhoriz•
THIS PERMIT
AUTHORIZES
This application Is not a permit until
state laws regulat construction;
etl thereby, no person wIII be employed In violation of the Labor
ONLY THE
WORK NOTED
signed by the Building Official or hmmer
Deputy; and lees are paid. and receipt Is
Coda 01 the State of Washington relating to Workmen's Compensa•
aCknOWletlged In Space provided
lion Insurance avid RCW 8.27.
S� A RE (OWNER O AGEN I
DAtE SIGNE
INSPECTION
DEPARTMENT
OFFICI SIGN E CA'E
/ I6t
+•I
CITY'OF
l V>/,
1 r/
EDMONDS
:I.
ATTENTION
CALL FOR
INSPECTION
eL A. ED D. wir
OCCUPY A BUILDING OR STRUCTURE
IT IS UNLAWFUL TO USE OR M
UNTIL A FINAL INSPECTION HAS BEEN AGE AND APPROVAL OR
a
771®"ZO
ORIGINAL - c,z YELLO:Y - Inscector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
1DE IBT
PINK - O+.�er GOLD - Assessor
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RECORD OF INSPECTIONS
-
i
INSPECTOR
DATE APPROVED
I
SETBACKS ...................
FOUNDATION:
-
Footing ....................
-
Wan.......................
! ...::.
Pier/Porch................ .
i - -
Retaining Wall...........•
_
-
Slab Insulation............
PLUMBING:
Underground .............
Rough -in . ............... .
I -
Commercial Final........ .
...- .'
HEATING:.
.
Gas Test
Ges Pipmg .....
,..
Equipment ....
. 1
- Commercial Final .........
-
iEXTERIOR
SHEATHING
...
NAILING ....................
FRAMING ...................
INSULATION:'.
Floor Insulation...........
'.�.. Well Insulation ...........
.- -
Ceiling Insulation..........
t.
-
- SHEETROCK NAILING ....:.