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PERMIT EXPIRES
CITY OF EDMONDS
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'B 5-g NUMBIER 980830
CONSTRUCTION PERMIT APPLICATION
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LEGAL GT:SCRIPTICN CHECK
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LID NO
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PUBI IC RIGHT OF WAY PER OFI'ICIAL STREET MAP
EXISTING REQUtAIDDEDICATION
PROPOSED
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NAME
METER SIZE
LINE 517.E
NO OF FI%TURFS
PTIV REOUIRE(1
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YES ❑ NO ❑ -
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REMARKS 2
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TELEPHONE
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ENGINEERING MEMO DATED REVIEWED By
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ADDRESS
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FIRE MEMO DATED REVIEWED BY
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VARIANCE OR CU
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E%PIRATION DATE TE ELICENSE NUMBER
FWM CKEDB
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SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEM
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ALLOWED OP/OSED
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ALLOWED ROPOSED
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LEGAL DESCRIPTION OF PROPERTY INCLUDE ALL EASE ENT
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EXP
l21
LOT COVERAGE
REQUIRED SETBACKS I1T.1
PROPOSED SETBACKS (FT)
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ALLOWED PROPOSED
FRONT SIDE REAR
FRONT VRSIDE REAR O
PROPEIjLY biA%Cf,(JUDNT PARCEL O. ;
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LOT AREA
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❑ NEW G'I RESIDENTIAL ❑ PLUMBING/MECH
REMARK'I
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❑ ADDITION❑ COMMERCIAL ❑ CHANGE OF USE
REMODEL ❑ APARTMENT ❑ SIGN
❑ REPAIR ❑ GRADING FENCE CYDS ❑ 1 X FT)
CHECKED BY
TYPP OF UN
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❑ DEMOLISH ❑ TANK ❑ OTHER
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SPECIAL INSPECTOR AREA
REQUIRED ❑ YES
}.� OCCUPANT
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GARAGE
❑ CARPORT ❑ RETAIINING WALL ❑ RENEWAL
CKER
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(TYPE OF USE. B}}J�SINE SS O{+ACTIVITY) EXPLAIN:
REMARKS O
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PROGRESS INSPECTIONS PER UBC 108 -
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NUMBER
STORIES
STORIES
NUMBER OF
DWELLING
UNITS L' C�
CRITICAL •AR AS /��1^J✓�
NUMBER t! G�
RIB[ ORK TO BE GONE
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FINAL INSPECTION REQUIRED
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE
GLAZING
LOT SLOPE "e
BUILDING
PLAN CHECK NO:
vesTEO DATE
PLUMBING
MECHANICAL
-
-
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE ONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN ( CURSS.SIDEWALKS, DRIVEWAYS, MAROUEES,ETC.) WILL REQUIRE
GRADING,FILL
STATE SURCHARGE
_
SEPARATE PERMISSION.
PERMIT APPLICATION: 100 DAYS
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS
STORM DRAINAGE FEES
'APnLICANT ON BEI{ALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCE. SORS ENG. INSPECTION FEE
11i iN TEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS PROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIREC TLY
FIp EOM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF 11115 PERMif SHALL NO BE PLAN CHECK DEPOSIT
p DEEMED TO MODIFY, OFOR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
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TOTAL AMOUNT DUE 1�
I HEREHY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, Tl1z' INFORMATION
GIVEN IS CORRECT. AND THAT ANT THE OWNER. OR THE DULY AU I'., .- .'ED AGENT OF APPLICATION APPROVAL
THE OWNER. AT I AGREE TOCOMPLY WITH CITY AND STE LAWS REGULATING CONS TRUC CALL Thla application is not a p—d until a,gnatl by tho
I ION. AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Bu MIng OII¢al or hislher Dopuly'. and Faos are paltl. :Intl
IN VIOLATION OF THE LABOR COOS F THE STATE OF WASHINGTON RELATING TO FOR INSPECTION rOfIlF. l 1 halholetlgetlm and F,os a,etl.
%V014KMEN'S COMP , SATI INSU NO RCW 1821
SIGNA 'IOW �ROR�� GATE SIGNED (425) O IALS NATURE DATE
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A FINAL ItPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UDC SECTION 109
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab 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 ..................' —!
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