20020420.pdff
DATE RECEIVED-
PERMIT EXPIRES ? i
USE r PERMIT
CITY OF EDMONDS ZONE ��� I� NUMfajEA
CONSTRUCTION PERMIT APPLICATION ADDRESS ! �/' / SUITE/APT#
NAME/NAME OF BUSINESS
G M I PAT NAME SUBDIVISION NO LOT MO. LID NO.
G A D[R'SSS / (} LID FEE f f
1 �� 0/ Is � PUBLIC I�rDPWit PBIM0IFICIAI'GREEZABAP __._ uwaw, n
ZIP TELEPHONE `^""'-+•y....-.uroanfsrxT'gnx'yl
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rNAME METE 1IN- jZE NO. OF FIXTURES
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REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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ZIP TELEPHONE Re ardless of ft-T%f I
is open or closed, etoansion tanks are
NA E raguire on all hot wilicr tanks per
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—ENGINEER[ 0/DATE
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FIRE REVIEWED BY DATE
CjTY
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VARIANCE OR CU SHORELINE OR ADB# IN BOND
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STATE LICENSE NUMBER EXPIRATION ATE C y REO'D POSTED
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P PERTY TAX ACCOUNT PARCEL NO. '\ COMP TE �t !,i
pp�� i'+66E0--PROPOSED
0 ';or &
16D / EXP c'ate .;+ AIACIllS�.i
EW �flESiDENT1AL UMBIN /MECH LO PROPOSED FRONT •SIDEAR aI ►It .
ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE HEAR
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ADDITION COMMERCIAL COMPLIANCE OR
❑ ❑ CHANGE OF USE
SS
PARKING NI R 0 Y DATE
REMODEL APARTMENT REGO PROVIDED 'I� yft ��1 i 6�75.2
❑ ❑ ❑ SIGN y�'
W4T SERVICE SHUTnFI'
GRADING FENCE
❑ REPAIR ❑ eyes ❑ ( — X Fr) REMARKSINSTALLED ON THE
❑ DEMOLISH ❑ TANK ❑ OTHER •-. .. ,- f„
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❑ GARAGE CARPORT ❑ ROCKERYRENEWALINING WALL ❑ RENEWAL
(TYPE OF USE, BUSINESS OR ACTN E%P
OCCUPANTg
CHECNEO BY NPE ON3T CTION C
GROUP
NUMBER NUMBF.fl OF CRITICAL
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OF j� /� DWELLING AREAS /} / SPECIAL INSPECTOR AREA OCCUPANT
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STORIES •r LSi,' UNITS NUMBER �(i REQUIRED❑YES LOAD
DESCRIBE WORK TO BE DONE /
REMARKS PIJR' TY'YL FF
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PROGRESS INSP G �'OBI9WL IWI&VMNI REQ'O
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SHALL BE INS VALVE(PRV)
8
FHE WATER SIIUTOIT
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VALUATION $
Description
FEE
Description
FEE
Plan Check
_
HEAT SO CE GLAZING % LOT SLOPE %
Building
P CHECK NO: vesTED DATE
Plumbing
^f
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
4 BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
Recording F88
� DOMAIN (CURBS, SIDEWALKS,DRIVEWAYS, MARQUEES, ETC.) REQUIRE
SEPARATEPERMISSION.
$
Engr. Review
City Surcharge
l �
PERMR APPLICATION: IN DAYS
PERMIT LIMIT.i YEAR• PROVIDED WORK IS STARTED WITHIN IN DAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
9 EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fite Review
Receipt A'
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OH INDIRECTLY
rs
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT E
<j DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANBCE
Fire inspection
Total Amount DUD
2 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Landscapeinsp.
ReceiptN
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
ThB nPplinagon innola ppr I—til nignntl
by lhp
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION HE LA BO .QOOE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Building Oilicinl pr Ma/hnt Oppwy: and Faae—paid,
—.1pl is ncRn.wI.dg.d in apoco
and
prmidN.
WORKMEN'S O NSATI IN U NCE AND RCW 13.2].
OFFICIALS SIGNATUR
DATA
SIG OR 'ENT) DATE IGNED
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RELEASED BY
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EXT1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING STRUCTURE UNTIL
i71-O221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELLOW.
INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER GOLD -ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ........:
. .
` - FOUNDATION:
- Footing ..........
„3
V Wall........................... .....
Z'.
PledPorch ..........
m
' Retaining Wall
"
Slab Insulation ..........
- ..
PLUMBING:
Cm..
Underground
O
....:.:...
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Rough -in ......... _
..
ITIITI
`'
.Commercial Final :...... _
O
HEATING:..
>1i.•
Gas. Test
`�i.
t�(��
:,"
,n • .
Gas Piping ...
_AGL::t
- Equipment ...........
..
M ITI ,.
m,
..
PPP
Commercial Firiai .......
Q
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EXTERIOR SHEATHING -
NAILING "..........................m
:FRAMING ,.......:: ..
2tmn-'
1;.
FIRST, FLOOR FRAMING.,.
DDD
INSULATION ...........
Z.
i
Floor insulation ..........
'
` Wail insulation
(:
i
Gelling Insulation .......
"
rn
i. SHEETROCK NAILING ...
-
SPECIAL INSPECTION ...
-
f - MISCELLANEOUS ..........
-
f FINAL APPROVAL FOR
! OCCUPANCY .................. V `
I -
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