20000195.pdfus PERMIT
CIT7 OF-EDMONDS ZONE NUMBER 2C)OI95-
CONSTRUCTION PERMIT APPLICATION ca SU�TEIAIT
A ... ESS
WINER N AME Of BUSINESS
LEGAL DIESCRIP—N
VqX
IIIUIY:�El�
0 PUBLIC FIGHT OF WAY 1. 0111�'.L STREET MAP. TESCIP App—,d 0
CITY ZIP TEL RW P11.1t R1114 0
FE.IJIRCD DEDICATION SINKII Ule PI-1 R� d 0
R—NIKi
POSED S,d—k R—,,d C1
NAME
METERSIZE I LINE SIZE NO. OF FIXTURES PRV RE U 'RED
YES 13 No 0
STATE
P,
TIRMI..,
Pamel No.
ElNEW
DENT IAL
RESIDENTIAL
PI UMBINGIMSCH
F-1 ADDITION
CIAL
COMMERCIAL
El Go .ER
CO PLIANCE OR
CHANGE OF USE
—1 REMODEL
APE'
.L. G
APT. SLOG.
T
El SIGN
REPAIR
GRAOING cyos
FENCE
(—X—i
DEMOLISH
INSODST
El wo OVE
E9T
SWIM POOL
HOT TUB/SPA
E] GARAGE
CARPORT
r-1 RETAINING WALL/
" ROOKERY
RENEWAL
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
N MESH
U
OF
NUMBER OF
DWELUN Q
AREAS
NUMBER
IN
DESCRIBE WORK TO BE DONE (A7T`AGN 11-1 ILRNI
VARIANCE OR CU
ADS N
SHORELINE
SERA REVIEW
COMPLETE I EXEMPT
EXP
SIGN
ALLOWED
AREA
IPROPOSED
HEIGHT
ALLOW 0
PROPOSED
LOT COVERAGE
ALLOWED I PROPOSED
REQUIRED SETBACKS (F-E)
FRONT SIDE HEAR
PROPOSE SETBACKS (Fr.)
FRONT UR SIDE REAR
LOT AREA
PLANNING RF7EW7--[--'77E
REMARKS
TYPE 0,
I ri C NECKED BY CONSTRUCTION
JOC
ORC OU NT
upe--�
SPEC
AEQI
1001111"T
LOAD
MARKS
PROGRESS INSPECTIONS PER LIBC 108
FINAL INSPECTION REOUIRED
CHECK FEE
HEAT SOURCE:
O/C
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers ork to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewolks.
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: ISO Data
STORM DRAINAGE FEE
Permit Limit: 1 Year - Provided Work Is Started Within 180 Daye
Appllca behalf of his or her spouse, heirs, assigns and
�01'n'.'..', to Indemnify. defend and hold
C ....... agrees
S -c m..S it, 0, Edmonds '� Shl
her In a ngton, its officials
igents from any �nd 11 . aims for damages Oi
W a ever In a directly or indirectly from the Issuance
I ' 0, this sl.�l not 11. deemed to PLAN CHECK DEPOSIT
of this pe mit. Su8nce permit
modify . Zam,a or red.. any r.ciu"Smant 0 any city ordinance
any ordinance
DUE
nor limit I n any way the City's ability to enforce
provision."
TOTAL AMOUNT
vf.OwL
I
hereby go In' I �:s a pllcatlon; that the
ac'"Ow::c
ATTENTION
APPLICATION APPROVAL
In n Ivan Correct! and '"hat I'a thepowner, or the duly
formatto
adlhor"6d go - owner. I to comply w" In city and
THIS P RMT
Th is ap on is no' `mh u 'i'
P,",`hBtE.iIdIn,
I, - I doing Ile Work authorl.-
Stole laws :,Un.i0ng`.h.n.,Nj. on. and n
AUTHORIZES
ONLY THE
or h her
signed 011"Z-71 I S/n
ad thereby. no person will be em�loyedl In Violation of the Labor
WOR K NOTED
Deputy: and fee s are paid, and receipt is
Code of the State of Washington relating to Workman's Compensa,
acknowledged in space provided.
tion Insurance "-CI RCW 16.27.
INSPECTION
DEPARTMENT
TURI IIWZF—R—OR AGENT) NED
TUR, DATE
CITY OF
L
EDMONDS
CALL FOR
RELE A
ATTENTION
INSPECTION
IT IS UNLAWFUL To UST�, OF, CC A BUILDING OR STRUCTURE
.SPEC ON HAS U13PEYEN MADE AND APPROVAL OR 771-0220
ORIGINAL — FOS YELLOW -- Inspector
UNTIL A FINAL
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. LIBC
A11eS1-1
SECTION 109
R`—
PINK — owner GOLD —
z
0 M
0
0
80
M
M Z
jO--4
o -n
n
M M
0 5)
0
0 Fri
0
z
ca
z
0
d
0
171
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...................
FOUNDATION:
Footing ....................
wall� ................. ......
0
Fl r/P rch:
RetainingWall ............ .
.
Irl
Slab Insulation ............
�n
PLUMBING:
ITI
Underground .......
C
M
Rough -in .......
0 C
Commercial Final ........
IT11
I'D z
HEATING:
JO
C
GasTest .................
w
6aspiping ................
0,3
Equipment ................
Commercial Final .........
i
X
M M
EXTER106 SHEATHING
NAILING ..... .............. .
. ...
co,
FRAMING ....................
0
17,
iNsmu Tiow
X
Floor I naulation ...........
Wall Insulation ...........
C elling Insulation .........
z
SHEETROCK NAILING ......
0
SPECIAL INSPECTION ......
IT,
MISCELLANEOUS
FINAL APPROVAL
FOR OCCUPANCY ...........
PEAMI
CITY OF EDMONDS ZONE UMBT
cc� IN ER
CONSTRUCTION PERMIT APPLICATION
"INES tADDAE
LEGAI S— L
-tru-
JO�N11177"INAMI 0
LEGAL ;;Io,
2914 0 6
PUILII RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Appond 0
zj'
TELEPHONE NUMBER
Aw P,-I R—d
XISTING REQUIRED DEDICATION —
EX'
E
SIN,., U1. I. -I Req d 0
m-,j 20
774 J-�
I.ETER.Q.
0
PROPOSED
Sid-11, R"1111d 0
LINE S1770.
OF FIXTURES
PRV RECUR D
I
I YES 0 NO 13
EXPIRATION DATE
COMPLETE I EXEMPT ALLOWED I PROPOSED
EXP
LOT COVERAGE RE. IRIE.— -'K- I" I
ALLOWED I PROPOSED FURONT SIDE FEAR
ia Z&unt
Parcel No.
REMARKS
'LUMB"'7 'C
E] NEW 0 RESIDENTIAL PLUMBIN
C. OR
COMPLIA CEOR
Ej
[I ADDITION COMMERCIAL COHANGE OF USE
APT. BLDG. I N
El SIGN
REMODEL C CD CCUP"T
HECKED BY OF 0 TION G OU
3R—NG FENCE
FENCE R
C:—
110PA
REPAIR [j cy., L—X—FT)
4L
A. CC
Wo DIVE -L UIA.T
on A.
DEMOLISH T
- T
INSODST
-T Us 'S IEB�
-E RETAINING WALL/ RENEWAL
-.AZA.FT 0 RENEWAL REMARKS
R OCK
PROGRESS INSPECTIONS PER UBC 108
0
9
NUMBER NUMBER OF CRITICAL
AREAS
oF UN TLL HG NUMBER
1.
STORM.
DESCRIBE WORK To BE p�NEE(AYTACHI PLOT PLANI
FINAL INSPECTION
REQUIRED
VALUATION
FEE
BUILDING
HEAT SOURCE: G�ING
PLUMBING
Plan Check No.
MECHANICAL
This Pa it covers work to be done on private property ONLY.
rm
GRADINGIFILL
I UC on (CurbE Ik
Any cons r if on he pub EjdewP S�.
'u..., Etc., wfl,=ln �,
driveways, me Sapara 8 PermISEIo
STATE SURCHARGE
Pamli Application: 180 Days
STORM DRAINAGE FEE
Permit Limit: I Year - Provided Work is Started Within 180 Days
..A.p%1fc,3.nt,no1n b8ha�! o,,his hernspou.sle IT assigns an d ENG. INSPECTION FEE
. . r..:ro dam �ho If
nt.r. d a nd and hoi
su
CC a officla
City of Edmonds a'
harmless the th
ClIrgIcn,
aim. of
empGy:aSBa.nrd agents from By �nd'tlsl or'damages
whets, e. rising directly or Incilrectiy, from the issuance
Issuance of this parmit she I not be doe med to PLAN CHECK DEPOSIT
of this permit.
modify, w Iva or reduce any requ rement o any cut o
a rZ=nCe
nor limit In any way the City's ability to enforce any ord
TOTAL AMOUNT DUE
provision."
thatt"
IhorebyIIck"Owj:d16tha I�nd1t"1111.;n`h'"1-n:r
ATTENTION
APPLICATION APPROVAL
o'
informallo n 'Ivan Or' G,� . hall I a ow , r the duly
authorized agent of the owner. I agree I. Comply with city and
THIS PERM IT
This application is not a permit until
Ing and In doing the work authorlZ
Let C.
to laws reg'
AUTHC�I'ES
signed by the Building Official or his/he r
:ta
d I areby, no person will be employed in violation of the Labor
ONLY THE
�No_ N o'Eo
I
Deputy; and fees are paid, and receipt a
Code of the State of Washington relating to Workmen's Compensa.
acknowledged In sfpa�e provided.
tion I nsurance aria RCW 18.27.
INSPECTION
DEPART"EIT
HER OR AGENTI SIG—
O11IClA1 S IIGNAT
JOITI
.IT1
EDMONODFS
7k��— C
DATE
TENTION
FOR ,
INSPECTION
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING o' STRUCTURE
HAS BEEN MADE AND APP-6-11 OR
771-0220
IGINAL — F;I. i(EILI-6�% — 1-pelto, L
UNTIL A FINAL INSPECTO
A CERTIFICATE OF OCICUPANCY HAS BEEN GRANTED. USC
SECT ON 109
I
PINK Owr.ef GOLD — Ass-EsOl
z
C ITI
,a . I
0
80
C
-1 K
3:
M z
0 n
n
M ITI
0
17,
0 M
M
z 0
z
(j)
z
ITI