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20000000.pdfDATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION MAILING ADDRESS ZIP ITEL11"111 "IY01(a -2bG-2-W-03�1 ADDRESS CITY NAME 44H ADD11111 CITY ZIP TELEPHONE PERMIT EXPIRES USE PERMIT r ZONE NUMBER ,3,100000 SUITEIAPTN J08 ADDRESS V766 No. PLAT 7NAMEISUBDIVISI.N NO, L11 NO I'D No T LID FEE $ T ssp Ess A,,d I S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP sh_ Us- 11 s EXISTING — PROPOSED— his P.,11,111d REQUIRED DEDICATION— FT Ussii,s—d ss LINE SZ S PIT, I, U METER SIZE LINE SIZE NO. OF FI.TURS1 PPW REQUIIED S . N YES 0 No FIRS REVIEWED By DATE AXING STATE LICENSE NUMBER E3YES ONO SERA REVIEW COMPLETE EXEMPT SIGN AREA AL ED PROPOSED HEIGHT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO, jj� —01 EXP LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACK' (1) S_ �A.BITI.11 PLUMBING/MECH ALLOWED PROPOSED FRONT SIDE AFAR FRONT UASIDE REAR Fo COMPLIA CEOR CHANGEDFUSE LOT ARE PLANNING REVIEWED By DATE ej�XIEMODEL 0 SIGN PA AEaD I PROVIDED REPAIR FE14CE GRADING CYDS 1:1 ( _ X FT� n DEMOLISH 0 TANK o OTHER 0 GARAGET AETAKjNJRN�G WALL C] RENEWAL CARP.A 90C (TYPE OF USE, BUSINESS OR ACTIVITY) EX —IN: <;;CK ED ';PE 1111, ION 0 C 7:2 GAOUuM NUMBER N 0 UM AIR OR TICAL AREAS CIAL R 'REQUIRED OCCU T OF STORIES D LUNG UNITS N YES LOAD DESCRIBE WOA TO BE DONE PINS =A111 OFF! liar 10SIFINAL INSPECTION REO VALUATION PLAN CHECK FES LOT SLOPE I BUILDING PLAN CHECK NO: PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO ROPERTY ONLY, ANY CONST GRADINGIFILL BE DONE ON PRIVATE P AUCTION PUBLO JOWITHE DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MA DUE ES, ETC. LLREQUI E 3 SEPARATE PERMISSION, STATE SURCHARGE PERMIT APPUCATION: 181 DAYS PERMIT LIMIT: I YEAR ' PROVIDED WORK IS STARTED WITHIN 180 DAYS ENS. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE EIIII,ASSIGNSAWI�UCCEEORS ENG, INSPECTION FEE N�. IN INTEREST AGREES To INDEMNIFY DEFEND . D HARMLESS THE CITY OF LANDSCAPIN ED..�.,,,WAS.IN.T...�T�OFFIC,,,AL,,,M,,OElI IIAIENTSIA.MANYAND INSPECTION FEE T EA NATURE Ag,,, ALL CLAIMS FOR DAMAGESOF WHA , ...'AECTLYOR INDIRECTLY RECEIPT ___ THIS PERMIT SHALL NOT BE DEPOSIT F TH SUANCE OF THIS PERMJT� ISS ANCE OF PLAN CHECK G IS CE A GUIREMENTOF ANYCITY ORDINANCE D t 0 IFY OU ANY SENS To Moo OR EEFORCE ANY ORDINANCE PAOVISION�� RECEIPT/ Ll �WAIVE N OALIMTINANY W YTHE CITY7A BILITY, TOTAL AMOUNT DUE AT 1.EI.F A.ATK)N H AppLK;AT APPLI I HERE Y ACKNOWLEDGE THAT I AVe A�A-,T,-'�' A . " E A THE � AUTHORIZED AGENT OF GIUN This apPI—I GIVEN IS COR'ECT� AND THAT I AM THE TRUC- CALL CIT AN6 STATE LAWS REGULATING CONS TIE DINER. I AGREE To COMPLY WITH S"i dih, Offi-I DOING T WORK AUTH Ey THEREBY, NO PERSON WILL BE EMPLOYED h—P, is TION, AND IN IN VIOLATION OF THEELABOR CODEo0FKZTDE STATE OF WASHINGTON RE ATING TO FOR INSPECTION WORKMEN'S COMPENSATION INSU CE AND RCWI812 . OFFI L 17 PORA I DATEJIGNEDY (425) W 00 RE - __ / g 771-OZZU RE SAS f ( DATE 'im A;FE7N13N EXT 333 ............ IT IS UNLAWFULTO USE OR OCCUI(`YABUILDING OR STRUCTURE UNTIL 771-0221 - ORIGINAL -FILE . -INSPECTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- YELLOW CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER - GOLD -ASSESSOR 5,98 z 0 0 a M c M 0 80 c m IT z 0:2 z 0 n m IT O,_ 0 m c CD c 10 A z z z 9 0 m RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ............... Wall.................... Pier/Porch ................. Retainlrig Wall ........... Z 0 Slab Insulation -4 M PLUV": —I -n Underground ............ tJ Rough -in ................... M, Commercial Final M HEATING: -4 C M Gas Test ................ M 10 z 1 Gas Piping ................. > -4 Equipment .......... Commercial Final n ;D EXTERIOR SHEATHING M M J'�� _NAILING ............. ............ Co �FRAMING ........................ FIRST FLOOR FRAMING C 0) M 0 INSULATION ........... Floor Insulation Wall Insulation ........... Ceiling Insulation SHEETROCK NAILING z SPECIAL INSPECTION 171 MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY ............. can 2." ,m ATE RECEIVE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS ASAJ MAILING ADDRESS VA.01- ST-- -S.W. CITY ZIP TELEPHONE IP7 wu rm 1117, -1 muD 2&_ � 2-w- (3 ADDRESS CITY ZIP NAME (—X,>0 ADDRESS k_ CITY' ZIP STATE LICENSE NUMBER -1 LO fa-uua 0 NEW RESIDENTIAL PLUMBING I MECH C3 ADDITION COMMERCIAL o COMPL ANCE OR CHANGE OF USE En-�EMOOEL 0 APARTMENT SIGN E3 REPAIR 0 GRADING CYGS IENC9 ( — X FT) C] DEMOLISH E3 TANK 0 OTHER ciGARAGE 17-1 RETAININD WALL 0 RENEWAL CARPORT — OCKER A, (TYPE OF USE, BUSIN 'TIVITY, EXPLAIN: jU F�MB�ER OF C ITICAL ToR DWELLING A EAS BE NUMBER UNITS NUMBER DESCRIBE WORK TO BE DONE MARKS PERMIT EXPIRES 44 X - - - 7SE PERMIT 'E05C.067-7 ZONE NUMBER JOB SUITEIAPTII ADDRESS q f760 qd iL, `sr s PLAT NAMEISUBDIVISION NO. LOT NO, L NO, I L:D D FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP PW II., U.. _.II AI� EXISTING — PROPOSED REQUIRED DEDICATION— FT & REQUIRED 10 NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE ENGINEERING REVJEWED/DATE z FIRE REVIEWED BY DATE r VARIANCE 08 CU SHORELINE 014 ADS. INSPECTION RED D J,IOND6 STE C3YES SERA REVIEW SIGN AREA HEIGHT COMPLETE I EXEMPT ALLOWED I PROPOSED ALLOWED , PROPOSED m EXP m 0 1_0 COVERAGE REDSETSACKS(FT) PROPOSED S ETBACKS (FT.) a, ALLOWED PROPOSED FRONT SIDE REAR �RONT U SIDE REAR c: 3: M PAR I� LOT A��ID BY DATE m 10 PEOG R—AAK. 181 E: o -n 0 m M CTiON IV G011CUr!2_> 0 SPECIAL INSPECTOR REQUIRED 0 YES JAREA LOAD 0 I:= P,9111"Ilz 4_71 fl) PROGRESS INSPECTIONS PER UBC I08/FINAL INSPECTION RIEWD 5 j > J minj r. n z VALUATION FEE z PLAN CHECK FEE 0 m HEAT SOURCE OIAIING I LOT SLOPE I BUILDING 411;-. 00 PLARCHECK NO: jV11TED DATE PLUMBING MECHANICAL THIS PERMIT AUTHO IZES ONLY THE WORK NOTE.. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 DOMAIN ICURSS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE GRAIXNGIFILL SEPARATE PERMISSION. STATE SURCHARGE PERMIT APPLICATION: ISODAYS 1YEAR-PROVIDED ORK IS STARTED WITHIN 181IDAYS PERMIT LIMIT: W E ENG. REVIEW FEES SEE SACK OF PINK PERMIT FOR MORE INFORMATION ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESOpS ENG. INSPECTION FEE ;APPLICANT, N INTEREST, AGREES To DEFEND AND HOLD HARMLESS THE CITY OF I-ANDSCAPIN :NDSMNIFY, 2 EDMONDS. WASHINGTON. TS FFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND NSPECTION FEE R CTLY ALLCI-AIMS FOR DAMAGESOF WHATEVER NATURE, ARISING DIRECTLYOR IINCIRECTLY TE—CEIPT F ROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT D EMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE C 2, ISION OR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROV RECEIPT/ '-IS 73 /-/5 TOTAL AMOUNT DUE i I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION AL APPLICATION APPROVAL LI�AT I GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF 'A m - � P.-I THEOWNE I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- NO PERSON WILL BE EMPLOYED CALL 001 �q 0,,,., O.p.1y: nd F. r,,J TION. AND IN DOING THE WORK AD HORIZED THEREBY THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION, POVI�d._ IN Viol ATION OF WORKMEN'S COMPENSATIONINS RAyCE�.NDRCW18.27� OFR . /DATE j DATUIGNEZ J425) *L 771 9220 BE AS DATE ATTER—ION EXT 333 FUL TO US E 0 R OCCU(Y A BU ILDI NO OR STRUCTU RE U NTI L IT IS UNLAW 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL,FI1_E YELLOW. INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR