20000160.pdfCITY T ...
F.00,;2 0 �d'
NAME
CITY
2_0 71 ;t
NAME
j F"lu
AGIOSEll
CITY TSL .. ONE
STATE LICENSE NUMBER
FKRMIT EXPIRES
USE
PERMIT
ZON
NUMBER
ADDRESS
SU TE/APT#
FLAT NAMEISUBDIVISION
NO,
LOT NO.
11D NO.
11. FEE
TESCP 4pl—d
LIC RIGHT OF WAY PER OFFICIAL STREET MAP
- P.I. P ..
�" J.. P.—
EXISTING —
PROPOSED—
I-- R.
REOUIREDDEIXCATION� FT
V REQUIRED
SO NO 0
YEP
APAPONSIBLE
FOR EROSION CONTROUDMAINAGE
FIRE REVIEWED By
DATE
4-�AIQ V tj 2S.6-96= SERA REVIEW SIGN AREA
COMPLETE I EXEMPT U.LOWED PROPOSED ALLOWED PROPOSED
PROPERTY TAX ACCOUNT
'2111L 10,
EXP
=PMPS
LOT COVERAGE
REQUIRED SETBACKS (FT.)
FRONT SIDE REAR
PROPOSED SETBACKS ( )
FRONT UPSIDE REAR
0 NEW kg RESIDENTIAL C3 PLUMBING I MECH
ALLOWED PROPOSED
COMPLIANCE OR
lk ADDITION 0 COMMERCIAL 0 CHANGE OF USE
LOT
DATE
0 REMODEL 0 APARTMENT 0 SIGN
PARKING
REG D I PROVIDED
— C:] IEN�E
C] REPAIR 0 !!ZL CY.. I — X ITI
1EMAR-
0 DEMOLISH [3 TANK ci OTHER
ARA-E RETAINING WALL
Cl CARPORT 11 RGGXERY
0
BUSINESS RACTIVITY)EXPLA
CHECKED BY
TYPE OF CONSTRUCTION
OCCUPANT
JCO
GROUP
NUMBER
NU,,E,,,,
CRIIICIL
AREAS
SPECIAL INSPECTOR
AREA CA.DLPA.T
10
L.
OF
o STORIES
OWELL NO
UNIT.
R(2A
NUMBE le-9111
REQUIRED E] YES
, DESCRIBE WORK TO BE DONE
PLAN CHECK FEE
HEAT SOURCE GLAIIN LOT SLOPE I
BUILDING
PLAN CHECK NO: STED DATE
r,
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADING/FILL
DOMAIN (CURBS, VEWAYS, MARQUEES. ETC.) WILL REQUIRE
SIDEWALKS. DRI
3 SEPARATE PERMISSION.
S RINARGI
PERMIT APPUCATION: 140 DAYS
_IAT�S
PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG REVIEW FEES
SEE IAC73F PINK PERMIT FOR MORE INFORMATION
ENO. INSPECTION FEE
ON BEHALF F His OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
THE CITY OF
;APPLICANT.
N INTEREST. AGREES TO �NDEMNIFY. DEFEND AND HOLD HARMLESS
TS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
LANOSG�G
INSI Ee 5 1 9 E
�IR CTLY OR INDIRECTLY
RI
P:RMIT SHALL NOT BE
PLAN CHECK DEPOSIT
)F ANY CITY ORDINANCE
PROVISION. -
)RDINANCE
TOTAL AMOUNT DUE
I IER11Y ACKA D E T HAVT READ THIS APPLICATION; THAT THE INFORMATION
OWLIE r
' T"
IS A. R,.�GD AD OF
CORRECT, AND THAT HE OWNER. OR THE DULLy�AUTHQT
G "S N
N:.T
THE OWNER. I AGREE TO COMPLY WITH CITY AND STAT LAW EGLI, '0 TRUC-
CALL
T ED THEREBY, NO PERSON WILL BE EMPLOYED
ION, AND IN DOING THE WORK AUTHORIZ RELATING TO
FOR INSPECTION
I N VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
WORKMEN*S COMPENSATION INSURANCE A W, .2 .
9WNER OR AGENTF ATE SIG14ED
Og
(425)
_ _"?edo
9-3- do
3
771-0220
-At%NTION
EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 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
5198
4'--- 0'c-
VALUATION
m
2111�
't"' I, , piIII iped 4y tho
hI C.puly:.�d F .. p.d. ld
Is 11=10dood iy" pl—d-
ORIGINAL - FILE - YELLOW � INSPECTOR
PINK - OWNER - GOLD � ASSESSOR
z
0
a rn
c
m
0
c:
m m
Z
-14
coll
0
63
mm
0
0
Fn
X
z
—1
z
m
FINAL PROJECT APPROVAL FORM
z
0
=Pii
m
mo
--1 0
0 0
c
m m
z
10 --1
c: z
o -n
n
mm
0
0
m
U)
M
Z
;u
z
--i
in
z
0
m
2.
1
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvl.doc.l:temp:bldg:fomIS6/98
RECORD OF INSPECTIONS
j
INSPECTOR DATE APPROVED
SETBACKS .............
FOUNDATION:
9 ...................
wall ..........................
Pler/Porch .................
p
i
�Ozl
Retalnirig Wall ...........
Slab Insulation
o-
PLUMBING:
Underground .............
Q)
ff
Rough -in ................
M
commercialfinal
HEATING:
Gas.Test
M
z
Gas Piping .................
Equipment , .................
0),
comm.,cial Final
EXTERIOR SHEATHING,
M III:
NAILING ........................
Fn'
FRAMING, ...........
C 0),
C cni
FIRST FL60R FRAMING
INSULATIOW;.:
ITI 0
Floot Insulation
-4,
Wall Insul ation
z
Ceiling Insulation
SHEETROCK NAILING
Z�
SPECIAL INSPECTION
M
MIS CELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
—2—a— —I
BLOD
I L
%J, FP-ER.11 EXP"REs
CITY OF EDMONDS
PERMIT 205 60
.14
N E
� 2 NUMBER
/2C6
'0
CONSTRUCTION PERMIT APPLICATION JOB
ADDRESS
AV
B SUITVAPTN
A
DID E5� /,,'o 6 _Z '
L
OWNER NAMEINAME OF BUSINESS
ve e /1/(p A
P T NAME' D LOT NW
PI -AT NAMEISUBDIVISION NO. LOT No��
N_
LID NO
I'-
FEE S
S.
A�
z MAILING ADDRESS
P BLIC FIGHT OF WAY PER OFlICIAl STREET MAP
U
IS
EXIS ING— PROPOSED-
G
T N FT
AIOUIREDDIDICITIIN— FT
'E.-P A-- 0
P.- ."o., 0
U.. I.— A �O
7 .
U.. 0
A" d
R
_&.d
CITY ZIP
2W,11�11/s
111EPHO E
12,2V-250
METER SIZE
LINE SIZE
NO. OF FIXTURES
'.ED
PRV REQUIRED
Y S . .
YES C3 NO 0
NAME
REMARKS
OWNERYCONTRACTOR RESPONSIBLE FOR EROS19�,QONTROUDRAINAGE
CITY ZIP
A /I- b
NAME
144
a
E..NE.AW. REVIEWEDIDATE
ADDRESS
0
z
p
m
CM
"o"
0
FIRE REVIEWED BY DATE
CITY ZIP
z el a
TELEPHONE
VARIANCE OR CU
SHORELINE OR AOBN
INSPECTI
REQ-DON
OYEK -NO
JPBOTEDD
OSN
TATE LICENS=ENUMMBER
S T T L
PROP Y o
pp
7 W fix PA7 19
_7EPA REVIEW
COMPLETE EXEMPT
EXP
I.N AREA
ALLOWED PR POSSE I
HEIGHT
ALLOWED PROPOSED
NEW C] PLUMBING MECH
-W
t[RADDITION
COVERAGE
ALLGWTE C PROPOSED
REQUIRED SETBA KS
FRONT SIDE GRUA
POPOSED SETBACKS (FT.)
P REAR
FRONT UR SIDE
C MPLIANCEOR
cl 1:1 CHANGE OF USE
m
AKIN
BY DATE
P Aml
0 REMODEL 0 0 SIGN
CYDS C3 FENCE
FT)
FT)
[3 REPAIR . — — )
PA
REG' P
10
r-
A A KS
, i�
I bow
OTHER
0 DEMOLISH C] TANK
a
0
'AGE RETAI INGWALL
A Ry RENEWAL
0 lG;A.'PCRT 0 OCKNF
-
In
mm
0
0 f
c r
c cn
M 0
Z
r yE OF USE. BUSINESS CA ACTIVITY) EXPLAIN:
CHICKEODY JTYPEOIC.N�TRUCTIION
CUPANT
1C."S JOG CUP
NU BER
OF
STORIES
SPECIAL INSPECTOR JAREA
REQUIRED [3 YES
OCCU ANT
LOAD
DESCRIBE WORK TO BE DONE
REMARKS PECTION REO'D
PROGRESS INSPECTIONS PER UBC 108/FINAL INS
c, (Z-
t
z
ri)
z
VALUATION
FEE
PLAN CHECK FEE
'o
T SLOPE %
HEAT SOURCE GLAZING LF UILDING m
�11TIIUIIE PLUMBING
PLAN CHECK NO:
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
DOE ON FIR VATS PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DONE I
OMAIN (CURBS. SIDEWALKS, DRIVEWAYS , MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT'. I YEAR - PROVIDED WORK IS STARTS WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
I A E SP SE.HEI S. SSIGNSANDSUCCESORS
I E T, A REES T INDE IFY, DEFEND AND A L DHA LESS T E ITY F LAND69APiNG
I FFICIALS. E PL YEES. N A E TS FR ANYAND INSPeer&�E
N S. ASHINGT N. ITS
E
ALL t SF DA ES F HAIEVER NAT RE.ARISIN I TLY DIRE TLY RECEII
FA EISSUANCE F THIS PER IT. ISSUANCE F THIS PER IT SHALL N T 8 FLAI CHECK DEPOSIT I
A E E T DIFY. Al E A REOU E ANY RE Ul I E T I ANY ITY RICH AN : - I
DE T E EPA VI I N.
N A U TIMANY AY THE CITY'S ABILITY NF RCEANY RDINAN
IHIREBYACKNOWL OGETHATT:AH.AVTIRIA THIS APPLICATION; THAT THE INIF RMATI N
TE H HE 00 NSA. OR THE DULY AUTHORIZED A Thl, IPPI-cal� M P't ig,,d by IhO
IS C.RAE. W THORIZEDA ENTOF
T".
GIVEN T�7
.AN.T A P,.d. nd
AND STATE LAWS REGULATING CONSTRUC T'll 11
C Y d,� Otf,�W .1 hWhIII D.P.1y:
THE OWNER AGREE ToCoMFLYWITFR'lT d
DOING THE A T, ' ED CALL 5.11 ; z�, 'I'f 11�1: ,.Y,d.d.
TION: AND ED TH EFIEBY, NO PERSON WILL BE EM LOY R I N pj.k,,wIadg.dl
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FO NSPECTIO
WORKMEN'S COMPENSATION INSURANCE A CW 18,27. OFFICIAL lqpiA�TUR 7 AT
SIGNAT (QWNER A AGENT) DATE SIGNED (425)
_,3 ATE
771-0220 FELS ED By'
NTION EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
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
SETBACKS.: .........
FOUNDATION:
_4f
Footl�g.. ........
z
Wall ........... .......
7:,
Pledpor6h ...... :.7.7
RetathingWall ........ 4.1.
=j
Sl.bl�sulatlon., ....
7,
PLUMBING -
Underground...
Rough -in .................
r;
M
Cornmer�lal Final ..
c Z�,
HEATING:
2/W
(�Test ....... .......
V6
0-n
GasPIpIng ......
_Irl
Equipment ....... ........
m
0
Cornmen:1alFinal .........
0
EXTERIOR SHEATHING
a co):
NA ILING .............
7 .
ir
m 0,
z
FRAMING .................
INSULATION:
Floorinsulatiom ........ --7-
Z
Wall Insulation ...........
IE
l� L