990603.pdfie,g1y.1Wa/9t,- f4d7?• Su211
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME, NAME OF BUSINESS
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21P TELEPHONE NUMBEI
L 14111
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- `♦ ZII TELEPHONE NUMBE
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DENS NUMBER EXPIAA
Description of Property - Include all easements'
PERMIT 9 3a 603
�- NUMBER iJ F7 l/
SUIT
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18011PTION CHECK
SUBDIVISION NO
LIO NO
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RIGHT OF WAY PEA OFFICIAL STREET MAP
TESCF ApprgveeRWPe,mlt
G REOUTAED DEDICATION
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Slrl Ufa Permit Req'yqygED
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R OUIPED
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lED AT/�
EKING MEMO UgTE �I,:qa VtEW(E a9
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OATED EWE, By
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%RESIDENTIAL
,X.I PLUMBINGRAECH
COMMERCIAL
COMPLIANCES' _ "
CHANGE OF USE"
tA..ITION
REMODEL
REPAIR
APT. SLOG.
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CYDS.
SIGN
FENCE CH
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WOODSINSERT
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AGE
CARPORT
ROCKERYGA G WALU
❑ RENEWAL RE
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TYPE OF USE, BUSINESS OR I A LAIN
NUMBER
OF
STORIES
NUMBEI OF
DWELLING w'p
UNITS Dl vl.
AREAS
CRITICAL cr T
NUMBER
c oIRF WORK TO BE DONE
(ATTACH PLOT PLAN)
VIEW SIGN
EXEMPT ALLOWED
=RAGE REOUIREDS
PROPOSED FRONT
HEIGH:
FRONT UH BI,C n n
1D 5/7, T �� e
Fo AN cl-e "� LdAD t
<YES T�Iti
'INSPECTIONS PER USC 108
fn 0 FINAL
INSPECTION
REQUIRED
VALUATION
FEE
PLAN
CHECK FEE
3 BUILDING
HEAT SOl1AC�03 tq% GLAZING/ e/ PLUMBING
�®
Plan Check No. v(`6 MECHANICAL
This Permit lovers 'work to be done on private property ONLY. GRADINGIFUL
w
Any Construction on the publld domain (curbs, sldewPiks,
drlVeweys, marq Ueee, etc.) will require separate permission. STATE
SURCHARGE
permit AppllCetlOn: 180 Daya STORM
Permit Umit:1 Vear _Provided Work is Started Within 180 Days
DRAINAGE FEE
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INSPECTION FEE
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-:5 CD
Z�$ ( 6 —
"Applicant, on behalf of his or her spouse, heirs, assigns and ENO.
A successors in interest, agrees to indemnify, defend and hold
w harmless the City of Edmonds, Washington. Itsofficials, `3RUl;
aemployees, and agents fromapy and all claims for damages of
whatever nature, arising directly or Indirectly from the Issuance.,
X of this permit. Issuance of this permit shall not be deemed to
omodlly, waive or reduce any requirement of any city ordinance
z nor Ilmit In any way the Clty's ability to enforce any ordinance
PLAN CHECK DEPOSIT
r
TOTAL AMOUNT OUE
U
provision."
I hereby acknowledge that I have read this application; that the
inlormatlon given Is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and
stale laws regulating construction; and In doing the work authorii•
ad thereby, no person will be employed In violation of the Labor
Code of the State of Washington relating to Workmen's Cc Dense
tion Insure Id RCW 18.27,
RE OWNER R AGENT( DATE SIGNED
1 �1
ATTENTION
THIS PERMIT
1UTHCA1ZEs
OML
WORMY HE
N
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
APPLICATION .APPROVAL
This application is not a permit until '•
signed by the Building Official or his/her
Deputy: and lees are paid and receipt is
acknowledged in space provided.
OFF ICIAL5 SIGNATURE tl
% /L/,L•JJ✓l-.
CALL FOR
ATE
RELEASE E
i
ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
AND APPROVAL OR
771-0220
IGINAL — Fds YELLOW — Inspector
UNTIL A FINAL INSPECTION HAS BEEN MADE
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. r�
O
SECTION 109
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L- /
n
PINK — Owe, GOLD — Assessor
v R
99elv03
EXPIRES: r a ao
r 'ISSUED: �110 �9R
' } City Of Edmonds
THIS CARD MUST BE POSTED ON SITE AND AVAILABLE TO THE INSPECTOR
I:
Owneri Dl1ESTA0
Slle Address: /S7,Z2 'Y'J /��ALL WuT Side Height:
�l Variance R:
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En ineer ng 11 0 .1�llb .5� .91W QY
Pebtie�.Vevks SQ�.ru
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FINAL OCCUPANCY APPROVAL
BUILDING 4 INSPECTOR
THfa HIILDIN6 OR ANY PORILOILTH€HEOF IS NtlT TO @E9ccUPIEQ.eFR LBG IOJ LINTiL AI 1
APPI I A LE CITY Dt:PARTMFNTS HAVV GRANTED A FINAL APPROVAL
(425) 771-0220 x 333 For BUILDING INSPECTIONS
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FINAL PROJECT APPROVAL My
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
E; FROM: FIltE DEPARTMENT DATE
ENGINEERING DIVISION DATER
i4 rno
Y PLANNING DIVISION DATE
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PROJECT i�1IQS 11
SITE ADDRESS 512Z I
PERMIT # ADB# DATE INSPECTED �I'�19� 0
qq� ion 3 �--
DESCRIPTION OF WORK TO BE INSPECTED�I
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of:
__-Yinal approval of the described work
Performance Bonds associated with the project maybe released
!� _GRANT FINAL PROJECT APPROVAL
J GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
I.
i
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
i
ocaprvl.doc.l:temp:bldg:forms6/98
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETB,Il ......... .
FOUNDATION:
Footing ....................
Well .......................
Pier/Porch................
Retalning Wall............
Slabinsulatlon............
PLUMBING:
Underground........ ..
Ro�atta-t►1 PwNnAAb�
Rough -In ...... ... ...
F�fY°✓�'6y67� SSA -X-5 '�IayaO
Commercial Final........
.HEATING: .
Ges Test........ _
Ges PlPing.......... ....
Equipment... ...
Commercial Flnel.. .....
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OX7- Sft"A/ Y
EXTERIOR SHEATHING
NAILING ................
fit{ /IN4y AYi+G1
FRAMING ....................
Ti%i f'Si% ,d14, /�
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INSULATION:
Fioorinsulation.......... ,
_. �. Wall insulation...........
Ceiling Insulation.........
V .
I _C -
SHEETROCK NAILING ......
SPECIAL INSPECTION......
MISCELLANEOUS
- -
FINAL APPROVAL
FOROCCUPANCY..........
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