20000147.pdfk�
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
CITY ZIP
- 11 to - 2-21
ADDRESS
PRO
NAME
SINYN07 ps
- DILE
ADDRESS
CITY ZIP
TELEPHONE
STATE LICENSE NUMBER
EXPIRATION O�
1�\ I c'q e� b I o (o 112E-2-jo
ft�LFGAL DESCRIPTION OF PROPERTY - INCLUDE
ALL EASEMENTS
< FPr ERTY T CCOUNT PARCEL NO.
I X� rn - 0 -7
c)
NEW
RESIDENTIAL
LU- ING I MECH
X LU
ADDITION
0 CQ..ERCIAL
o COMPLIANCE OR
CHANGE OF USE
REMODEL
_;ZL APARTMENT
0
0 REPAIR
—omr-Y.-
FENCE
0 x FT)
0 DEMOLISH
0 TANK
E] OTHER
2AFAN�T
0 R�ETAKININY6 WALL
oG E�
0 RENEWAL
P (TYPE OF USE. BUSINESS
OR AC
NUMBER
OF
STORIES
NUM ERoF
DW ING
UNIELL
TS
CRITICAL
A EAS
NUMBER 9
DES=DONE
c t cyl
k:b -
9,\C� 4r)_-r,\N -3 a^-yr)
/ L
Z!!�ORK NOTED. THIS PERMIT COVERS WORK TO
THIS P RMIT AUTHORIZES ONLY
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN JCURBS,SIDEWALKS, DRIVEWAYS. MARQUEES,ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 18DDAYS
PERMITILIMIT1 YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS
;APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
N NTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY 01
EDMONDS, ASHINGTON. ITS OFFICIALS, EMPLOYEES. NO AGENTS PRO. AN, AND
ALLCL IMSFORDAMAGE OFWHATEVEH NATURE ARISING DIRECTLY OR INDIRECTLY
PERMIT EXPIRES
ZONE r=3&- PERMIT 200147
UMBER
JOB
ADDRESS
LEGAL DIS141PTIOI CHICT—T
NO,
I
LIO NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING REQUIRED DEDICATION
PROPOSED
METER SIZE
/p
LINE SIll
NO. OF FIXTURES
!1_7
PRI IOU,I.RED
YES 0
REMARKS
ZC�61'-O
�eV-
MEMO DATED REV'
��Ilbllll
fENGINEERIIG
RE, -, y
VARIANCE OR CU
ADBX
JAPO :22-111
SEPA REVIEW
COMPLETE EXEMPT
g_ I _
EXP
SIGN AREA
ALLOWED
;;4=SED
HEIGHT
ALLOWED I 11OPI 8"
14r 5 t6-
LO COVERAGE
ALLOWED PROP05ED
46 5*b I
REQUIRED SETBACKS (ET.)
FRONT SIDE REAR
Itf If 0 /!Jr
PROPOSED SETBACKS (FT.)
FRONT OR SIDE REAR
J!5' 1410 17
LOT AREA
PLANNING REVIEW By DATE
REMA
Ltiacz Sm4p 4 3-1, 0(o
AFA!Y I
TYPF P40RUCTION
OCCUPANT-
JCJE) I GROUP KI /L)l
EQUI..D' YES
t--�'EMARKS
LOAD
loccr�4�
PROGRESS INSPECTIONS PER UBC 108
" fl� -
FINAL INSPECTION REQUIRED
ILLATION
FEE
PLAN CHECK FEE
.703
BUILDING
qpYls_
�11719
PLUMBING
500
MECHANICAL
70
GRAGINGIFILL
STATE SURCHARGE
5
ENG. INSPECTION FEE
7
FROM THE ISSUANCE OF THI S PERMIT SSU NCE OF TI 11 S P ERMI f SHALL NOT B E
I
C ITY ORDIN
G�EMEDTO MODIFY. WAIVE OR REDUCEANY REQUIREMENT OF ANCE
PLAN CHECK DEPOSIT
N PHUVISION -
OPLIMIT IN ANY WAY THE CITY'SABILITY TO ENFORCE ANY OnDINAr CE "UVISION
TOTAL AMOUNT DUE
go
I HENEBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. TH INFORMATION
GiVEN I E CORRECT, AND T AT I AM THE OWNER. OR THE DULY AUI It, ED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULAI ING CONSTRUC
CALL
�,g by ft
T ION. AND IN DOING T HE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN
B N,111, Dlp,lty .11d F w. pa.
VIGJATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RE LATING TO
W=j IN S GOMPEN�SATI SUIT N N I
FOR INSPECTION
P'
-
I DATE St7D
(425)
OFF L, SIGIATI R A'E
V,
771-022 0
ATTEWON
o
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
'919-ijo
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL FILE -'YELLOW INSPECTOR
PINK OWNER - GOLO ASSESSOR
z
9 -
0
c: rn
m a
__Io
00
c:
rTi rn
c
E:
54)
0 -n
n
m M
0
0
0
c
M 0
Z-i
z
0)
z
0
occupancy established by this certificate:
h�
Rl/Ui
Maximum OCCupant'LC
Root�. capsCRY'Sil
t
MENT OF BUILDINGS
UNIFORM BUILDING CODE SEC'nO
BuiIding,PqMIt-#: #20 '47
Dwelling Units: -3" No. Stories: 2
Type Construction- V-N llv,, Basement: No
kd 1),134. 1002)
ns,. U d wpmpin posted at 0,11mes.
n Bu dn n
G WITH THE REQUIREMENTS OF THE 1997
Di' IVISION OF OCCUPANCY AND THE USE FOR
'o �
0 Co sruct�
'o H
'ch SDNG O.E
ndo
M BU
O'v e" o' i M
T"E Tche 3 U ni C
EDITION 0, T E UN FOR CUP. CLAS
,.,C. TIE P.Op. ED 11
th'! 2001
BY:
,jo al ba pwad in pbllo and! shol not be _.,W. aabjd b-ed and DWI ba mInhilnd j biedonditionatalifinas
Co,,ii,ate ( 0o,,ipanoy minid by ft aty of Edraoadd WIding Official.
W
o
"I I
60
FIN,&L PROJECT APPROVAL k 0
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: __FIRE DEPARTMENT DATF/6-14
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE —
PROJECT C J692 4411A Z
SITE ADDRESS 2_'t",t g_—A Z�z
PERMIT #2go —Lq_7 ADB#______DATE INSPECTFD_Zd__—_2—_a__:!_d_.(_
DESCRIPTION OF WORK TO BE INSPECTED__§_
that
A field inspection was conducted to determine compliance with approved plans. Final approval denotes
there are no objections from the above signed Department to the granting of:
Final approval of the described work
GRANT FINAL PROJECT APPROVAL
—GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
I .
2. MICROFILM
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvl.doc.l:temp:bldg:forms6/98
z
0 1
0
C M
MO
0
80
M
M z
0 _q
it
0 -n
M M
a 5)
0
C,
M
co
M 0
Z
z
z
0
0
M
MCI PROJECT APPROVAL 5
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE-
zq
ENGINEERING DIVISION DATE 7 le4 I /"J/
PLANNING DIVISION DATE -
PROJECT
SITEADDRESS_._
PERMIT 4_20 ADB#______PATE INSPECT
DESCRIPTION OF WORK TO BE INSPECT
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
trn to the granting of:
there are no objections from the above signed Depar ent
-Final approval of the described work
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDII IONS NOTED
I
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
MICROFILM
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvl.doc.l:temp:bldg:fonns6/98
z
C M
MO
0
80
C
rn mz
jo -4
a
>
3:
0 _n
m rn
0
0
0 M
C Cn
r Cn
M 0
Z �
z
Cn
z
0 1
0
M
r
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ............... -
wall...................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
3
0
0
Underground .............
Rough -In ...................
commercial Final
M
HEATING:
M 0
0
0 2
Gas Test ..............
� C 1 r3
M
Gas Piping .................
IT!
Equipment .................
r
')
C
>
Commercial Final
EXTERIOR SHEATHING
0
NAILING ..........................
-14
M
FRAMING ........................
S
.5 -
M
INSULATION ............ IfYIN
0 f-
0 M i
Fioor Insulation
M 0:
Z
Wall Insulation ...........
-1
Ceiling insulation
Y-n
Cx-
;a
SHEETROCK NAILING
Z
SPECIAL INSPECTION
-7 2'f
z
MISCELLANEOUS ..........
0
9
FINAL APPROVAL FOR
0
M
OCCUPANCY ..................