20000079.pdfENED �_j PERMIT EXPIRES
USE
PERMIT
200079
CITY OF EDMONDS
f" NUMBER
CONSTRUCTION PERMIT APPLICATION JOB
ADDRESS
L
SSFPT,
6 RMAAl
�INE OF WE
PLAT NAME/SUBDIVISION NO.,
LOT NO.
L No
- A pnes.
L�D
0 FEE S
I MA INGA DRESS
. 5
,I A Pl, 6- Sl_r.
0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
IESC P, 'I U
RWP:Ap 0
�11.`.o 0
EXISTING — PROPOSED
0
0
CITY ZIP
TELEPHONE
42,5*- 77/- 7e'70
nIOUIREDDIDICATI.— FT
METER SIZE
LINE""
NO. OF FIXTURES
PRV REOUIHED
1-6CH,
I
YES 0 NO 0 9.
r
1.
ADDRESS
ICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
;;=S
REVIEWEDIDATE
m ADDRESS
S771-153�T
F] E IEW D
DATE
r
CITY ZIP
U,
TELEPHONE
-712:
S6:5 4
RIANC 1p CU
SHORELINE OR ADB#
INSPECTION 1PI30 D
OYREO'D OSTED
ES ONO
STATE LICENSE NUMBER EXPIRATIO
C_ 09/cl ll� C91 17
SERA REVIEW
COMPLETE EXEMPT
EXP
SIGN AREA
ALLOWED I PROPOSED
HEIGHT
ALLOWED PROPOSED
I PR0PEATyTAX ACCOUNTPAR
0 NEW PLUMBING i MEDIA
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (FT.)
FRONT SIDE REAR
PROPOSED SETBACKS (FT�
FRONT UPSIDE REAR
C MPLIANCE OR
ADDITION CHANGE OF USE
REMODEL SIGN
PARKING LOT
REDD I PROV,IDED
AREA
�NNI G REVIEWED BY 0
FENCE
El X
REPAIR cl GRADING CYDS FT)
MARKS
C3 DEMOLISH TANK E:] OTHER
e,
C] RETA.1N.INGWALL RENEWAL
El GCAA�"AGRET FOC
(TYPE OF USE. BUSINESS—L-11 11
CONOCM10114011 -------
CIECKEDly
ITYIE01CONSTZIOTION
OCCUPANT
10 ROUP rz)
j
I
NUMBER
OF
STORIES
7—
BE
LL OF
NDUIME ING
"TA
CRITICAL
A EAS IVA
NUMBER
ASPECT-07
SPEC,
LIALED
R
RE C] YES
A—REA
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
ROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REQ'D
C--�/ 7- 61IL&COlvY
R�Fgu wc
ve lo/o v,,-' nol"
&qT
VALUATION
FEE
PLAN CHECK FEE
105
HEAT SOURCE %
INV
BUILDING
VESTED DATE
AN CHECK NO: C) (r,
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIIES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU BUC
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MAROUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
GRADING/FILL
STATE SURCHARGE
PERMIT APPLICATION: IBD DAYS
PERMIT LIMIT' 1 AR � PROVIDED WORK IS STARTED WITHIN 180 DAYS
YE
SEE BACK OF PINK PERMIT FOR MORE INFORM ION
ENG REVIEW FEES
AP ANTjON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS N SC ES PIS
PLC D OF
N IN I ERES . AGREES To INDEMNIFY. DEFEND AND HOLD E L S T E CITY I'D
I T . FR ANYA
2 EDMONDS WASHIMOTONi ITSOFFICIALS. EMPLOYEES� AND
- ALL CLAIMEFORDAMAGE OFWHATEVEn NATURE, ARISING DIRE,-
FROM THE ISSUANCE 01 THI PERMIT. SSUANCE OF THIS PERMIT SHALL NOT BE
SQUIREMENT OF ANY CITY ORDINANCE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY R�
o NORLIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
ILAI
TOTAL AMOUNT DUE
oD
REC
REC 17 C—z
I HEREBY A 'EDGE 'HAT � AAMT READ THIS APPLICATION, THAT THE INF RMATION
E
GIVEN IS C=T A.., HAT HE OWNER. OR THE DULY AUlH0RIZ 0 AGENT OF
THE OWNER. I AGREE TO COMPLY WITI, CITY AND STATE LAWS REGULATING CONSTRUC-
TION� AND IN DOING THE WORK AUTHOPIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMENS COMPENSATION INSURANCE AND RCW 18-27,
�A�NTION
APPLICATION APPROVAL
Th,, �pplilltl Is "I - PDt u.I'I �,qn.d
CALL 130-g 011..ial , 1,11M01 DIPOV nd FOIX, V,,�o.p�ld.
. FOR INSPECTION o,,Ft,,klIod9ld 1� lQ PfO
OF S, E D TE
(425) �4
771-0220 IELE B ATE
EXT 333 a)
IT IS UNLAWFULTO USE OR OCCUll A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
771-0221 YELLOW - INSPECTOR
ORIGINAL FILE
FAX PINK.O.NER - GOLD -ASSESSOR
11B
z
0
m
m 00
,0
c:
co
0.11
"n
rn m
0
0
0 m
c (A
M 0
Z r,
z
z
0
0
m
z
0
i
0
:� 'fi
FA --4
0 m
C: m
m 0
0
80
C
m m
z
0 -n
-n
m
m M
0
0
0
c CM,
9 co
M 0
Z r-
7'�
M
z
(n
z
0
q
0
m
ocaprvl.doc.l:temp:bldg:fomis6/98
PERMIT EXPIR
Es"
PERMFT
C -OFEDMONDS 'ZONE 2
ITY NUMBER
CONSTRUCTION PERMIT APPLICATION JOB
U'
ZONI
S SUITEIRPT;
JNJAO.
ADDRESS
PI -AT NAMEtSUBDIVIStON NO. LOT NO. UDNO,_
A,514- P-1/2 LID FEE S
G ADDAESS
PU
52+ MAPIL.6 S'r. PUBLIC RIGHT OFWAY PER OFFICIAL STREET MAP "I U 0
.' "P_'u".1
EXISTING PROPOSE.— =.,, A.q
CITY ZIP TE EPHONE u
XDInONV REQUIRED DEDICATION— FT — ww
'25-, Z7/- 7aq0 —,—E—TE—, S,ZE_T__L,_, No, Or FIXTURES 18V REQUIRED
14
E YES 13 NO 13
ADDRESS AARKS
ROSION CONTRO
A IJr- /4,
OWNERYCONTRACTOR RESPONSIBLE
FOR E
o'
'TY ZIP
-?AlrA
TELEPHONE
7�W
2c& �Zot 7SW
NAME
c-ll.�'
REVIEWEDIIAI
IN G RIEVIEWEDIdATE
ADDRESS
m
Z
0 2
0
M
VI DATE
F E E
.5�/f�o ,
T
CITY zip
'75101-1
TELEPHONE
S5=�-71LI
VARIANCEbR CU
�IA
VA NO
I
SHORELINE OR ADO#
INSPECTION
RE .
C3 -_
YESO6.9
BOND
OSTED
t,
a ITT
c:
m a i
0
0
c
m rn
Z
>
0 -Ti
�j�DATE
STATE LICENSE NUMBER tC�
c- 63 fe / c, o" 9 1, 7
CHECKE Y
SERA RIEVIEW
COMPLETE I EXEMPT
EXP
SIGN AREA
ALI—Ell I PROPOSED
HEIGHT
ALLOWED , IFIOI.EED
PROPERTYTAX ACCOUNT RCELNO.
NEW 0 PL..B;NG/MECH._..1,,
PL'ANC
C MPLIANCE OR
M E 0
ADDITION F-1 CHANGE OF USE
AN BE 0, Us E
SIGN
0 REMODEL C] SIGN
FENCE
C] F NICE
REPAIR E] GRADING C,GS (E_ X FT)
i X FTi
THEF
C] DEMOLISH Cj TANK C] OTHER
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS R7.)
FRONT SIDE REAR
PROPOSED SETBACKS (FT)
FRONT UPSIDE REAR
PARKING
REDID I PROVIDED
RE'
LOT AREA
I �NtGEV BY
REMARKS
RE
�ro n7MOr- (�AA06,6
c3 GARAGE M TfETAININ WALL E W
FARPOR T G [3 RENEWAL
MAZ�MPLAIN:
-n
IT! m
0
o Fn
c (j)
M 0
Z
OF USE. BUSINESS
CHECKED BY
ITYPI OF CONSTRUCTION
OCCUPANT
CO G 1Z
ROUP
—....ER
F
�o STORIES
0
RITICAL
E S
AR A NA
Ill"MAIR
N..
Sp
R EEQCI,ALEIDNSPECTOR JAREA
RE UP YES
OCCUPANT
LOAD
QESCR!BEWORKTOB� PONE j
or ey17- &f.�-c-'vy
REMARKS'
PROGRESS INSPECTIONS
PER UBC 108/FINAL INSPECTION REO'D
;a
16)
>
Z
5f_--Ca&17y
ore/j slee oF6x7&E:-/Z--1o9- 6WT
co
VALUATION
FEE
Z
PLAN CHECK FEE
35
HEA SOURCE GLAzi I -POPE I
NA /.Jtt
BUILDING
m
PLAN CHECK NO: IVISTEO DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
:I SEPARATE P ON
GRADINGIrILL
A URCHARGE
PERMIT APPLICA-60N: 'Hid DAWS
PERMIT LIMIT'. I YEAR , PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
AN N BEHALF d, HIS OR HER SPOUSE, NEI RS. ASSIGNS AND SUdCiSdAS
PL C P &0A R ST.
��NPMTE G EE INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS WASHINGTON ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANYAND
, ALLC1_AIM!ii FOR DAMAGEi OF WHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY
3: FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS ERMIT SHALL NOT BE
9 DEZED T MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
ENG. REVIEW FEES
CAMD!Ie*�
ffqspee"em�
PLAN CHECK DEPOSIT
TIDTAL�MOUNT
" 5b,
V
P —45
RECE
I HERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMAT10N
8
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION. AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN 8 COMPENSATION INSURANCE AND RCW 18,27.
D E SIGNED
O��
APPLICATION APPROVAL
T'j$ pp,,o, I, .t , p11 U1111 liq,,ed by"'o
CAL B111d,,g olj�ml , hillft, Dop,ty:,,ld F p,,d.
FOR INSP ,ipt 1, ..kI*dq,d,,, p— vid,d.
TION
OF I I SIG 'D TE
(425)
=ER
:.-
I
�AI:TtNTION
771-0220 FEIE "I ATE
EXT 333
IT IS UNLAWFULTO USE OR OCCUPY ABUILDING OR STRUCTURE UNTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
ORIGINAL -FILE YELLOW - INSPECTOR
PINK -OWNER COLD'. ASSESSOR
I
RECORD OF INSPECTIONS
INSPECTOR DATEAPPROVED
SETBACKS ............ .. ...
FOUNDATION:
Footing .................
Z1,
Wall .......................
0
'./Porch�
RetainingWall ... ........
-n.
Slab Insulation..
PLUMBINGt
m
c 0
m
0
Underground .. ...........
C.)
0
Rough -In ...... 7
m
m Y
CommorcialFinal
Z,
HEATING:
U,
GasTest.... ...... .... .
0
GasPipin ql�_
j
Equ 1 pment..
MM
C,,m,rci,l Final . ........
C=
EXTERIOR SHEATHING
M 0
z
47FFf�� NAILING ........ .....
FRAMING ........... .... ...
INSULATION:
A
Floor Insulation
Wait Insulation .. .....
cn:
cl�
Calling Insulation ..... ...
SHEETROCK NAILING ......
m
SPECIAL INSPECTION ......
MISCELLANEOUS
FINAL APPROVAL Y'r-S
FOR OCCUIPANCY..
1060