930844.pdfUSE PERMIT
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CITY OF EDMONDS ZONE NUMBER 330
CONSTRUCTION PERMIT APPLICATION jog S ITE APT
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O 73 w PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved ❑
CITY ELEPHONE NUMBER RW Permit Required ❑
Y EXISTING REQUIRED DEDICATION Street Use Permit Req'd ❑
'T PROPOSED Inspection Required ❑
NAME Sidewalk Required ❑ ¢
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METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED <
YES ❑ NO ❑ 3
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REMARKS
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4 i1 E �f / i SIGN AREA SEPA REVIEW ADB NO.
(J jt (_ l`t O t ALLOWED PROPOSED COMPLETE EXEMPT
Legal Description of Property - include all easements !�? [�
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SETBACKS —FEET HEIGHT LOT COVERAGE Z
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Parcel No. -
NEW RESIDENTIAL PLUMBING
ADDITION COMMERCIAL MECHANICAL
® REMODEL APT. BLDG. El SIGN
CHECKED BY TYPE OF CONSTRUCTION CODE OCCUPANT
REPAIR ❑ GRADING FENCE ,^v� ` GROUP
DEMOLISH ❑ WOODSTOVE SPECTOY AREA LOADPANT
INSERT HOT TUB SPA REQUIRED
GARAGE ❑ RETAINING WALL/ ❑ES
CARPORTROCKERY RENEWAL REMARKS C
g(TYPE OFUS�SIIN�C! ACTIVITY)EXPLAw: PROGRESS INSPECTIONS PER UBC 305 0
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NUMBER NUMBER OF CRITICAL
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DESCRIBE W,Tri r,5)t.VACH PLOT PLAN)
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PLAN CHECK FEE
BUILDING 3�
HEAT SOURCE: GLAZING
% PLUMBING
Plan Check No. MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days STORM DRAINAGE FEE
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE
m successors in interest, agrees to indemnify, defend and hold
w harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
a whatever nature, arising directly or indirectly from the issuance PLAN CHECK DEPOSIT
= of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance `)
M nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL
information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and THIS PERMIT This application is not a permit until
state laws regulating construction; and in doing the work authoriz• AOUTHORIZES signed by the Building Official or his/her
ed thereby, no person will be employed in violation of the Labor WORK NOTED Deputy; and fees are paid, and receipt is
NLY THE
Code of the State of Washington relating to Workmen's Compensa• acknowledged in space provided.
tion Insurance and RCW 18.27. INSPECTION
SIGNA RE (OWNER AGENT) DATE SIGNED DEPARTMENT
OF AL' I NAT RE DAT
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3 EDMONDS P
CALL FOR ELEASED BY DATE
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771 ®�LA®
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOWyector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBCCHAPTER 3. PINK — Owner GOLD —sor
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .:.........
FOUNDATION: 1
Footing ....................
Wall...........
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Pier/Porch .. ......
Retaining Wall ::.....
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Slab Insulation.
PLUMBING:.
Underground ............
Rough -In ....:.
Commercial Final ...:.... ;
_ HEATING:
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Gas Piping . .. b
Equipment...... ......
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'Commercial Final
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NAILING
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FRAMING ........... ........
INSULATION: ,
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,:,Floor Insulation:..... ;
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Wall' Insulation,. ...... beebb�t� ,
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Ceiling Insulation
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SHEETROCK NAILING , .I ,. ?
SPECIAL INSPECTION ...... ', . k
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RADON MONITOR AT SITE .
FINAL APPROVAL
FOR OCCUPANCY........ __n../��'
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