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20000192.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF BUSINESS rn I c_�d d 1_,_0 A r,,2,.,/ MAILING ADDRESS �_j () ZIP I TELEPHONE ADDRESS PERMIT EXPIRES USE ZONE PERMIT 20019 NUMBER JOB SUITUAPT. ADDRESS pLAT NAME/SUBDIVISION NO. LID I'D' LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL ;T�7ET MAP Tad. in .'App 0 EXIST NO — PROPOSED an. .. P.nn, RIq d 0 I -in" 0 0 REOUIREODEOICATION� FT ia METEI1 SIZE 17�� PFIV REQUIRED YES . NO 0 NAME S�VIEWILVC ADDRESS FIRE REVIEWED By DATE CITY ZIP TELEPHONE VARIANCE OR CU V-0 INSPECTION JPBOND RIO'D OSTEI 0 YES STATE LICENSE NUMBER EXPIRATION DATE CHECKED By SERA REVIEW COMPLETE I EXEMPT .— A ALL G HEIGHT PR.P011D PROP ACCOUNT PARCEL NO. I Cl 06001 C E AGE OVP'R'OPOSED REQUIRED SETBACKS (Ft.) PROPOSED SETBACKS (FT) 0 NEW k RESIDENTIAL PLUMBINGeIrECH�) ALLGWTED FRONT SIDE REAR FRONT LIRSIDE REAR '&ADDITION COMPLIAN�; OR 0 COMMERCIAL 0 CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE KREMODEL [] APARTMENT 0 SIGN REaD I PROVIDED REPAIR [3 CYOS 0 FENCE ( _x _FT) EMARKI DEMOLISH 0 TANK o OTHER RU in 4- -7- o GAR 0 AGE 0 RETAIN NO WALL Rp,, CARPORT ITY7;USE, BU�S NESS OR ACTIV EXPLA CHECKED .. TPUC'RON _1�0_g_ CCUPANT "ROLF AID NUMBER NUMBEROF DWELL NO IT" AEA C'ES`�AL SPEC' INSPECTOR OCCUPANT LOAD OF IF, -1- — Z UNITS �J A REQUAL [RED YES J.HaA VALUATION I FEE PLAN CHECK FEE FOE GLAZING I LOT SLOPE % BUILDING ay'� PLAN CHECK NO: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO SE .. E 0. PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL QUEES, IETC�) WILL DOMAIN 'CU.... SIDEWALKS, DRIVEWAYS R REQUIRE PEFJ�JMA SEPARATE SSION. STATE SURCHARGE PE SMIT APPLICATION! 100 DAYS PERMIT LIMIT. I YEAR ADVISED WORK S STARTED WITHIN 180 DAYS ENS, REVIEW FEES SEE SACK OF PINK PERMIT FOR MORE INFORMATION ON BEHALF OF HIS 013 HER SPOUSE� HEIRS, ASSIGNS AND SUCCESORS THS CITY OF ENG. INSPECTION FEE ;APPLICANT, INTEREST. AGREES TO INDEMNIFY EFEND AND HOLD LESS 'I�LGF EDMONDS, WASHINGTON, ITS OFFIC S� EMPLOYEES. ANG= TS FROM ANY AND LANDSCAPING INSPECTION FEE ' ALLCLAIMSFOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY 11 NOT BE RE IPT FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT $HALL CITYORDINANCE PLAN CHECK DEPOSIT DEEMEDTO MODIFY, WAIVE OR REDUCE ANY PSOUIREMENTOF ANY TO ENFORCE ANY ORDINANCE P REC� NOR LIMIT IN ANY WAY THE CITY'S ABILITY TOTAL AMOUNT DUE ACKN . OWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL IHEREBY GIVEN AM THE UTATTES GUrLYIAUTHDT�INIIED AGENT 01 AND T AT � OWNER. CORREOTiE IS no Thi, ppli-o,on, no! no,, tantainginodby- TRUC THEITOINER. IAGR T----PL Y WITH CITYAND S LAW, ECULA CONS - CALL Sanding Oda,an .1 bil D oputy. and F — Paid, -ad TION; AND N DOING THE WORK AUTHO D THEREBY, NO PERSON WILL BE EMPLOYED RIZE TO FOR INSPECTIO N -nip, 1. .,,Xa—Iad,ad in 1p— al—nood. IN VIOLATION OF THE LABOR CODE OF THE STATE 01 WASHINGTON RELATING DATE WORKMEN'S COMPENSATION INSURANCE AND SCIN 18,21, (425) OF ALS SIGNATURE - -� - 6 -- - DATE SIGNED 3 ILI 771-0220 , RELEASED BY DATE EXT 333 ATTENTION ITIS UNLAWFULTO USE OR OCCUPY ABUILDING OR STRUCTURE UNTIL 771-0221 INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW, INSPECTOR GOLD - ASSESSOR I`j A FINAL CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK � OWNER - 5198 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall.......................... Pier/Porch ................. -4. Retaining Wall Stab insulation PLUMBING: Underground ........... M C M 0 Rough -in ................... Commercial Final M 10 HEATING: C K"'i k GasTest I ............. Gas Piping ............ 0 n Equipment ......... . In In, Commercial Final w rj) 'or EXTERIOR SHEATHING 0 rw� NAILING .................... IR 0 ,FRAMING .......... FIRST FLOOR FRAMING INSULATION ................... Floor Insulation Wait Insulation ........... Z: Ceiling Insulation SHEETROCK NAILING IT, SPECIAL INSPECTION MISCELLANEOUS FINAL APPROVAL FOR OCCUPANCY ............. ...... L ATE RECEIVED 'cl 2 PERMIT EXPIRES PERMIT CITY OF EDMONDS ZONE NUMBER 200-19-2. CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPTI ADDRESS OWNER N MEINAME OF BUSINESS P�T N, LID NO. �J vu LI. FEE I 5A By MAILING ADDRESS 0 0 z PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP R7 p n � _a 0 d' �.� ........ 0 1 1 CITY Z" EXISTING — PROPOSED — --a " 0 11 0 ITILSPHONE RE.UM.DS01�AJI.N_ FT 0 PRV REQUIRED NAME YES 13 NO ADDRESS 4L,,.k REMARKS z OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE TELEP ONE -),b NAME ENGINEERING REVIEWFOIDATE ADDRESS FIRE REVIEWED BY DATE CITY 0 Z VARIANCE OR CU SHORELINE OR ADBI0 IN T-7aGNTnTS. 9 STATE LICENSE NUMBER EXPIRATION E CHECKED By OYES ONO 0 SERA REVIEW SIGN AREA HEIGHT IT, COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED p OPOSED PROPII�Y TAX ACCOUNT PAIrEL NO. C', I , SXP LOT COVERAGE REQUIRED SETBACKS (�.) FRONT SIDE REAR PROPOSED SET AC S FRONT lJFS109 REAR 3: 0 NEW RESIDENTIAL ALL OWED PROPOSED a m c: bq,ADDITION COMMERCIAL o COMPL ANCE OR CHANGE OF USE m 0 0 PARKING DAT 0 8 ER REMODEL C] APARTMENT C] SIGN REOD I PROV, c: FENCE 3� a t - , 0 REPAIR 0 GRADING CYDS X Ft) REMARKS rn z .&AiksL sifts DEMOLISH TANK OTHSR C3 C I R CRT RETAINING WALL cl 0 RENEWAL 0 A A E ARPG 0 ROOKERY EXPLAIN: �Tl 71- L CHECKEDBY ITYP ION ICODE OOCUPANT 'Z GROUP gn I 0 -n NUMBER _Z I OF NUMBER IF DWELLING CRITICAL AREAS PPECIAL INSPECTOR JAREA .CUPA�7 SQUIRED STORIES UNITS NUMB. M YES MITI D11_1 TO "r DONE o L REMARKS PROGRESS INSPECTION$ PER USC 1081FINAL INSPECTION REO 55 0 0 Fn Ix_ v e- L) I,,( cy-v,\ or r VALUATION FEE z PLAN CHECK FEE - --------- L.IS BUILDING Z vAN CHECK NO: DATE PLUMBING IT! CHANICAL THIS PERMIT AUTHO ZES N RK NGTED.,THIS PERMIT COVERS WORK TO Rl 0 L YTH SWO N T E PUBLIC N Y A .T BEDONE N PR VATS PRO E TY0 N DO ST.U-'. L 1) 1 p R GR DINGIFILL Q ILHUU."' CUR SII)SWALKS DRIVEWAYS, MAROU EES,ET WILL.ECIUIR� DOMAIN ( SS' SEPA�ATE PERMISSION. STAT SURCHARGE PE Mi T APPLICATION: 180 DAYS PERMIT LIMIM I YEAR. PROVIDED WORK IS STA TED W $THIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICAT. ON BEHALF IF HIS OF, HER SPOUSE H.El.ROILA SIGNS AND SUCCESORS ENG, INSPECTION FEE IN INTEREST. AGREES TC "�DS.N"Y' DEFEND ':� D HARMLESS THE CITY OF AND A AGENTS FROM ANY OlONDS, WASHING EMPIUOYEES� ND E TON�S'.TS,,,,FT'�'�AE" INDIRECTLY NATURE, ALLCLaIMSFORDAM ARISING DIRECTLYOR THIS PERMIT $HALL NOT BE c FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF DEEMEDTOMODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANYCITY ORDINANCE TO ENFORCE ANY ORDINANCE PROV'E'.N,' PLAN CHECK DEPOSIT ClIPT 0 NOR LIMIT IN ANYWAYTHE CITY'S ABILITY TOTAL AMOUNT DUE IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION i PPROVAL GIVSN OR THE DULY AUTHORIZED AGENT OF IS CORRECT; AND THAT I AM THE NlFL CONSTRUC Thimappli3O-ill—all' tanal,ignadbythe �i� THE OWNER. I AGREE TO COMKpLyUWITHRCITy AND SETATENLOAWPS REGULATING By. ERSO� WILL BE EMPLOYED CALL ,dFad—deadpold. and TION; AND IN 0 ING THE WOR A THO ZED THER OF THS STATE OF WASHINGTON RELATING TO [FOR INSPECTION 0 I� ipl I, .k ... lodgla 11 IPI.e P11 IN VIOLATION OF THE LASO ODE WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27, OFPIC DATE 'MLS SIGNATURE -;R GENT) DATE 11GIED 425) -3 771-0220 E DATE L.LL_'- c_ EXT 333 REL S 0 ATTENTION 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 09 FAX PINK - OWNER GOLD - ASSESSOR