1998-0804 PERMIT0
ci
[PERMIT
EXPIRES
CITY OF EDMONDS
us PERMIT
zo U NUMBER
CONSTRUCTION PERMIT APPLICATION
ADDQ�11S
'0' ':9U) L� ST S 6V
LEGAL DESCRIPTION CHECK
I SUBDIVISION NO
LIIl NO
0 J 7 S (IJ
PUBLIC RIG141 OF WAY PER OFFICIAL STREET -A'
EXISTING — II1.UIFlGGEDICATI.fY_
PROPOSED
Tfs'p ARP-ld 0
0
Ll- 111- -11 0
0
0
L!71 I"
IIELEPHON'
METER SIZE
LINE BIll
OF FIXTURES
PRV REOUIRED
YES 13 No
REMARKS
77, ZIP
I El lPIlONl
lAl'r
ENGINEERING MEMO DATED REVIEWE D RY
ADORE
0
FIRE MEMO DATED AEVIEWEDBY
VARIANCE OR CU
AUB-
SHORELINE
—TIL 1 ICENSE NUMBER E-IRATION DAT'l
W-%�
F.
SERA REVIEW
SIGN AREA
HEIGHT
COMPLETE I EXEMPT
EXP
ALLOWED I PROPOSED
ALLOWED PROPOSED
I
E GAL DESCRIPTION Ot PROPERTY -INCLUDE ALL EASEMENTS
G
LOT C VERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS jFT)
FRONT SIDE REAR
PROPOSED SETBACKS (FT)
FRONT URSIDE REAR
u
IS rPEgy ACCO A
LOT AREA
PLANNING REVIEW BY DATE
NEW I MECH
ADDITION C MPUANCE OR
CHANGE OF USE
E] REMODEL 0 SIGN
REPAIR 0 GRA DING 0 IINCE
YD. , _ X FT)
CHECKEDBY
OCCUPANT
- __
DE.OL.S. TANK OTHER
=UCTION
ICODE
7 GROUP ff":3
SPECIALINSPECTOR' AREA
OCCUPANT
o GARAGE r-I REIAININGWALL
CARPORT ROCKERY 0 RENEWAL
E UIRED
A 0 1 YES
LOAD
�IYPEOF USEBUSlIZ11ACT11ITY) EXPLAIN:
REMARKS
E
PROGRESS INSPECTIONS PER UBC 108
1
'I.Ilps
NUMBEROF
D ELL NZ
UNITS
C ITICAL
A SAS
NUMBER
I -SCRISE WORK TO BE DONE
FINAL INSPECTION REQUIRED
ALUATiON
FEE
PLAN CHECK FEE
GLAZING
LOT SLOPE -6
BUILDING
PL" CHECK NO:
IVEITIO DATE
P LUMBING____
-
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. HIS PERMIT COVERS WORK TO
BEDONEON RIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
5 DOMAIN ICURBS,SIDEWALKS. DRIVEWAYS, MAROUEES.ETC.) WILL REQUIRE
—
GRADINGIFILL
STATE SURCHARGE
SEPARATE PERMISSION.
PERMIT APPLICATION: ISODAYS
I
PERMITLIMIT-1 YEAR - PROVIDED WORK IS STARTED WITHIN ISODAYS
STORM DRAINAGE FEES
-PLICAN7 ON BEHALF OF HI OR HER SPOUSE, HEMS. ASSIGNS AND SUCCESORS ENG. INSPECTION FEE
S SUC-E S.R. EN
I � N-IFS1, AGREES 10 INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY Or
S. T HE ':IT' OF
R M ANYA".
m ; ON-ONDS WASHINGTON ITSOFFICIALS EMPLOYEES, AND AGENTS FROM ANYAND
I
j
I NDI _TL'
'Er
x -NLL CLAWS �OR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
LL
L)Y THE ISSUANCE OF THIS PERMIT. ISSUANCE 01; T IS PERMIT SHALL NOT BE
I IT I PLAN CHECK DEPOSIT
0 LEEMED TO&4OLIFY. WAIVE OR REDUCE ANY REQUIREMENTOF ANY CITY ORDINANCE
NOR I IMIT IN ANY WAY THE CITY S ABILITY TO ENFORCE ANYORDINANCE PROVISION TOTAL A ... All DUE
I HEREB, ACKNOWLEDGE THATI HAVE READTHIS APPLICATION. THAT THE INFORMATION
GIVEN IS CORRECT AND THAT I AM THE OWNER OR THE DULY AU7H RIZED AGENT OF APPLICATION APPROVAL
�:4!EO NER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. CALL 7 h's appli"I'on " _1 . P.-t .01 "ped by th,
ON AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED 1"119 011,11.1 . hl�er Dopuly nd Foo, - Pmd, Ild
1% VIOLAII�N OE. LA."'N' DIE .1 lAlE .1 WASHINGTON FEIATIN. TO FOR INSPECTION ... ... �.d�d
IN CON' NSA U
4;GNATURE OVVNECAG.�f 0 SIGNATURE DATE
(425) _m
CA 7 -0220 7.
771 RELEASEDBy T DATE
ATTENTION
1 0
CATE OF OCCUPANCY HAS BEEN GRANTED UBCSECTION109
0
ORIGINAL FILE YELLOW INSPECTOR
PINK OWNER COLD ASSESSOR
P� "D
32 X �� Ll
ffi� Malsw
SETBACKS .....................
FOUNDATION:
Footing ......................
wall..........................
Pier/Porch .................
Retaining Wall ...........
Stab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
INSULATION ...........
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
I r ,
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
1 0 0
32X