20000216.pdfDATE RECEIVED
PERMIT EXPIRES
US,
.. MIT
CITY OF EDMONDS
ZONE
..... 2ooal'6.
CONSTRUCTION PERMIT APPLICATION
ADBERESS
SUITE/APT#
IER7MENAMEOF.B SINESS
P�VAMV.DIVISIO
LOT N
LID NO.2j4-
LOFEES A
.ING ADDRESS
4
OF WAY PER OFFICIAL
REETMAP
W � P. A',b
e" r-
PUBLIC FIGHT
EXISTING ---- PROPOSED
�11.----K.-.
TELEPHONE
RSGUIREDDEDICATION-- ---FT
U.-
METER SIZE LINE SIZE
q
NO. OF FIXTURES
PRV REOUNRED
ADDRESS
CITY ZIP
-7
. I 'j YEn NO
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE V&-S
NAME 4— A.) glt)
REVIEWEDIDATE
ENGME�7G 71;
z
ADDRESS
:S+
DATE
F114E REVIEWED BY
CITY
0
-VARIANCE OR CU HE OR ADBA INSPEC ION ..N.
POSTED
NUMBER
REO'D
�n
STATE LICENSE
Lc:\ 15-5
SSPA REVIEW SIG AREA HEIGHT
C E EXEMPT ED PROPOSED OWED PROPOSED
m
PROPERTY TAX ACCOUNT PARCEL NO,
'0
c:
m
0
�'-k'Au
EXPF
0 0
VMSIMENTIAL PLUMBING I .�CH
L T COVERAGE REOUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.)
ALL W PROPOSED FRONT SIDE REAR FRONT LIR ID REAR
11 z
c:
-
/10
rn
c3 C
0 COMMERCIAL COMPLIANCE OR
C] ADDITION HANGE OF USE
PARKING LOT AREA EGG
rn
[3 REMODEL APARTMENT 0 SIGN
REO'D P D
-z
FENCE
[3 REPAIR IYD. Cl X FT)
RKS
E:
V)
[3 DEMOLISH 0 TANK OTHER
0 -11
n
C LP.FT C, ... Y . 0
%�G4�RAGE RITAI�NING WALL RENEWAL
M
OF USE. BUSINESS 11
01 ECKED BY TYPEOIC3NSTRU ION CCUPA
ROUP
M
0
. NUMBER NUMBER OF CRITICAL
AREAS,
PANT
INSPEC R
- Fn
C ri)
DWELLING I �X
. OF NUMBE
0 STORIES UNITS
RPECIAL
EGUIAED Co] y S
c ch
DESCRIBE WORK TO BE D HE
0
z
M 0,
Z
RplMAAF'S REO'D
H GRESS INSPECTIONS, P R UBC 108/FINAL INSPECTIO
>
z
z
VALUATION FEE
0
PLAN CHECK FEE
2401
0
m
HEAT SOURCE GLAZING
LOT L %
BUILDING
00
PLAN CHECK NO:
YESTED DATE
PLUMBING
n
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADINGIFLLL
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS , MARQUEES, ETC.) WILL REOUIRE
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATI N: 180 DAYS
PERMIT LIMIT'. AR, PROVIDED WORK IS STARTED WITHIN 18D DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF.05 His OR HER SPOUSE. HEIAS. ASSIMNS AND SUCCESORS
ENG. INSPECTION FEE
J�ol
;APPLICANT.
N I AGREES T IN EMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
AND
l.TEllST=.ETS.`N,
ED N.S. W HINGTON. IT OFFICIALS. EMPLOYEES. AND AG ENTS FROM ANY
Gpwx*m��-
��L CLA INS 'OR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLIOR INDIRECTLY
OF THIS PERMIT SHALL NOT BE
I HECK DEPOSIT
E-P I
U H S P T. ISS ANCE
IS PERM,
I S AN.E OF T OF E .. EAN REQUIREMENT OF ANY CITY CROINANCE
'HE - . Y Y N'
DEE -ED TOM IF WAIVE
IRDVISI
PLAIN
j
RECEIPT
,TY%A.,LTy
,I NOR IMIT IN ANY W Y THE TO ENFORCE ANY ORDINANCE
TOTAL AMOUNT DUE
I HAVE READ THIS APPLICATION: THAT THE INPOR.ADON
APPLICATION AP 0 AL
I HE REBY ACKNOWLE ME THAT
GIVEN IS CORREC T,AND THATA . " . W THE DULY AUTHORIZED AGENT OF
l"'i
6oR s REGUI-ATINGCONSTRUC
THE OWNER. I AGREE TO COMPL Y WITHECITY"A��R
CALL
Q 'ty: "�.d F.
ESTATELAW
TION, AND IN DOING THE WORK AUTJ-IORIZED TH REBY. NO PERSON WILL BE EMPLOYED
TO
INSPECTION
.d
Pt,� -n-l.dpd -P- Pl-�-
IN VIOLATION OF THE LABOR COOE OF THE STATE OF WAS.INGTON RELATING
FOR
D E
WOPKMEN'�COMPENSATION INStANCE AND RCW 18.27,
OF Ic ON F
-fKm OR
E SIGNED
(425)
7'T -31 c-e>
771-0220
LEASED AT
EXT 333
�TE-NTION
70 USE OR OCCUPY A BUil-DING OR STRUCTURE UNTIL
771-0221
y ig UNLAWFUL
HAS BEEN MADE AND APPROVAL OR A CERTIFI.
ORIGINAL - FILE - YELLOW - INSPECTOR
- GOLD - ASSESSOR
A FINAL INSPECTION
BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER
CATE OF OCCUPANCY HAS
5m8
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
C:�CM� MY1tJ------ENG1NEERING DIVISION DATE
PLANNING DIVISION DATE
PROJEC
SITEADDRESS
Q0 # DATE INSPECTED�—
PERMIT �ADB
reN6hr,— $JAIA-L—
DESCRIPTION OF WORK TO BE INSPECTED —
A field inspection was conducted to determine compliance with approved plans. Final approval denotes . that
there are no objections from the above signed Department to the granting of:
inal approval of the described work
Bonds associated with the project may be released
GRANT FINAL PROJECT APPROVAL
GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvl.doc.l:temp:bldg:forms6/98
z
0
0
Cm
M 0
0
80
C
M
M z
z
0 -n
n
M M
0 Fn
0,
OM
C
M 0
Z
z
--I
29
Cn
z
0
0
M
Plot
Plan
HEIGHT CALCULATION
LOT COVERAGE CALCULATION
LEGAL- DE8CRIPTION R 'r:7 C E I V Tr- ?D
--------------------
JAN 3 1 2090
DEVELOPMENT 8PINMES G ' 'FL
WY OF EDV.O1R)8
0.
a M,
c 0 1
m
-4 O'�
0
m
C-Z�
>,
'mm
0
'0
z
0
M
. L
RECEIVED
JAN 3 1 20M
DF*IELOPMENT SERVICEs CTR.
CITY OF EDMONDS
ALL W NDOWS TO 5M
Window Schedule MILGAIRP VNYL
5-�'-
,1� 1/-/ 7L/-/-1 — /,/, -/,/u 11 -1.
rMcd:Y-7V7 2(110mx.
C,
M�
0 M,
rn
CO,
C
m m
0,
A M.
0
Fn'
C
Ch
0,
M.
m
C,
R
- - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
for Ac
— — — — — — — — — — — — — — —
- - - - - - - - - - -- - - - - -
Nk
1 P"i ,
--- - - - - - - - - - - - -
M
z 00
ij
m fn
IL
ly
- - - - - -
IL
m rn,
0
C:
T - --------
m
LL - - - - - - - - - - - - - - - - - - - - - - - - - - - - - i
It
- - - - - - - - - - - - - - - - - - -
7L:�
Z�'
M",
- - - - - - - - - - - - -
Z,
0
9
M
- - -
- - - - - - - - - - - - - - - - - - - - - - - - - - -
Heiqht Calculation Plan
R E: c r:, i v rr)
HE GMT CALCULATION LOT COVERAGE CALCULATION LEGAL DESCRIPTION-.
----------
----
------------ --------------------
JAN 3 1 21VO
---------- --
IDEVELOP24RIT
Al�
CTR
CITY OF
ig,
- — - — - — ---
W-
WASN
AC.M
----------
- — — —
----------------------------
— — — — — — — — — — — —
- �
a;w
N
- ----------
A
Z,
'F, - - - -
Z -
0
"y
------
t
m
L
mo�
o,
T,
IT.
L
10
c
ly,
o m
4
------
I-.
ZO
14
IT!
--J
row
v
0
m2w
c: CA!
gv
- - - - - - - - -
- - - - - - -
- - - - - - - - - -
M co),
1 L — — — — — — — — —
-
zi
NO TREES OVER
S' CIA.
L - - -
- - - - - -
-L - - - - - - - - - - - - - - - - - - - - - - - - - - 7- - -
m
Tree
Plan
HE GMT CALCULATION LOT COVERAGE CALCULATION
--------------------
LEGAL DESCRIPTION R
--------------
------------
w
---------------
JAN 3 1
A� ��i;'W
CITY ol-
. L
z
M,
--I -n
i V5 -j�
M&
c
M 0
-40
0 C
-4
Ix
m
m
Z
[MR,
IT, a
;
0
0
o R
I
c 0
c m
Z�
o"'w-
-
i , I
[ t,-;"
6� .
Grading Plan
15
R E r- E-% I V rm D
LOT COVERA09 CALCULATION LEGAL DESCRIPTION
HEIGHT CALCULATION -------------- -
---- --------
---------------
JAN 3 1 MO
---------------
I)EVELOPMEM -.CTR.
CITY OF W'."Xi
a.
IS RESPONSIBLE FOR
WE
L4
— — — — --- F AIDADDOMMWA9QUIRED
--1EMPORAR ----------
C=� "E
FT]vats
C-1 For
— — — — — — — — — — — — — — — — --
SLOPE IS RE TO BE LESS
-
-04
- ---------
'F-
- - - - - - - - - -
M,
rn 0
80
m
4-4—
Is
uj
-n,
>
y
0
J-1/
t
m In
------- ----
65,
0
0
0 F,
IL lw
c= (w
"M
—25'
— — — — — —
— — —
— — — — — — —
z;
I
IRFb
1 1 L — — — — — — — — — — — — —
z
coong
0.
M
66
L ------- - ------------------
Drainage Plan
K 7)
.1
HEIGHT CALCULATION LOT COVERAGE CALCULATIO
- - -
LEGAL DESCRIPTION
-------------
-TI j" 1.1013
- - - - - -
- - - - -
LOT
- - - - - - - - - - - - - -
LOT 2- %
F
ENGINEERING P,- AS NOTED
Project Review Checklist
Project Name:
Address:
Underground Wiring Required
Hydraulics Permit
Plat/Subdivision Requirements
Street Dedications
Easements - Public/Private
Engineering Storm Drain Review Feel
Engineering 2,2 inspection Fee
Drainage Plan (On -site)
Setback - Storm Drain Line
Open Ditch - Existing
culvert Required
Culvert Size
Shoulder Drainage/Shale Open R-Off
Catch Basin Required
Driveway Slope & vehicle Access
Sidewalk Required
Curb & Gutter Required
Curb Cut for Driveway Required
street Paving Required
Right -of -WAY Construction Permit Required
Bond Required for Public Improvements
FEMA Map CheckfWater Table
Side Sewer Availability
Calculate Sewer Fee ifNo LID#
Water Meter Size
water Meter Charge Required
Hydrant Required
Street Cut
Miscellaneous
RECEIVED
ftB"O -2 2000
0EP!
PuBL '3S
Plan Check #: -
Receipt Date; \ 131
RW Permit # Date Issued Receipt #
SSPennit# Date Issued SAC Receipt # 193&-0
Fire Connection$ Date Issued Receipt#
Paid s 2&0 Date VVF�— Receipt#
Meter Size r—
Z
C M
MO
--1 0
0 0
C
-4 r.
= M
MZ
10-4
0
A
X
M M
0
0
C rA
K co
M 0
Z
Z
Z
0
0
M
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wall..........................
Piet/Porch .................
Retainirfg Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
V�s
Rough -in ...................
Commercial Final
HEATING:
G Test ....................
as
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ................
FRAMING .......................
FIRST FLOOR FRAMING..
li"MILATION . . .............
Floor insulation
Wall Insulation ...........
Calling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
0
C, IT,
MO
—11 0
0 02
> z
n
fn m �k
0
2 0
z
0�
7:
'PERMIT
OWNERICONTRACTOR
EXPIRES�
CITY OF EDMONDS
.. PERMIT
NUMBER Ajj(bgk4(
SUITVAPT#
JOE
CONSTRUCTION PERMIT APPLICATION
I
u.
OWNER 7MEINAME OF INE
5;: -5 1 �cu-,o S S Y,
UDNO.2j4,
UDIEiEW/A
MAILINGADDRESS
_C_1
ic —
F
1US11. 1.111OPWAYIER0110ALST EETMAP
TESCPAPPI—d
11 p—, "lull"
S".., U.. 1.1. 4A
EXISTINRG �� PROPOSEO--Z�
CILTYL 70_JELBIFIONF.
REQUIRED DEDICATION FT
�3 7
Nj�
IETEI �ZE
I LINE SIZE
NO. OF FIXTURES
P REQUIRED
YES No
ADDRESS
R E.ARKS
E'
RESPONSIBLE FOR EROSION CONTROUDRAINAGE V&
CITY 27�---
FTELEIHONE
NAME
ENGIN55RIN
�=E
ADDRESS
FIRE REVIEiVFDSYV 1111111 1.90 1 I.WTE
CITY ZIP
TELEPHONE
VARIANCE OR OU
SHO EUNEORADB�
IM
STATE LICENSE NUMBER EXPIRATION 0
(.01 rN
CHEC�
—
---- --
:t!
SEPA REVIEW
SIGN AREA
HEIGHT
'WE PROPOSED
PROP�RTYTAX ACCOUNT PARCEL NO,
ooz)
EMPT
BED
- 0
[�2-NIEVV rRE E t- PLUMBING/MECH
ADDITION AL o COMPLIANCE OR
M E:,l
CC:D CHANGE OF USE
REMODE L U0 APARTMENT El SIGN
LOT COVERAGE
P ROPOSSID
REQUIRED SETBACKS (FT.)
FRONT SIDE REAR
d ;;�5�
4
PROPOSED SETBACKS (FT)
FRONT U AR
I - , ,
-;� A, 2 , —
-;�
PARKING
R _tp g=o 1;.�V
LOT AREA
1,
P IN ED.
�,
K g FENCE : .
0 REPAIR X FT) 1.
C3 DEMOLISH C] TANK C] OTHER
-AGE E] RITAIIM RENEWAL
CARPORT R.0 ErWAIL 0
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPI-Aft
.51 4e, tie r3±nk�� ae�,V��grg
CHFCKEDBY
TYPE OF 43,36�RU(IIN
ICODE _Dl O�..'Ni
CCUP TQ:��D
1:2A G
NUMBER
OF
STORIES IV,
NUMBER OF
DWELLING
UNI TS
C91TICAL
AREA
NUMBER
SPECIAL INSPECTOR
REQUIRED [3 YES
MPANT
-2A
DESCFIBE WqRk-TO BE DONE
REMARKS
�RnrRFqq INSPECTIONS PER UBC 108/FINAL INSPECTION REW
PLAN CHECK FEE
ARLA
LM
BUILDING
oo
PLUMBING
MECHANICAL
/10
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
OMAIN (CURBS, SIDEWALKS, DRIVEWAYS' MARQUEES, ETC.) WILL REQUIRE
0 MA IN ICU "BS 'S6EW'
GRADINGIFILL
0
I SEPARATE PERMISSION.
STATE SURCHARGE
PE MIT APPLICATION: 180 DAYS
ER'
PERMIT dMIT. 1 YEAR PROVIDED WORK IS STARTED WITHIN 160 DAYS
:EA F
I I p
END. REVIEW FEES
SEE BACK 01 PINK PERMIT FOR MORE INFORMATION
A y K
'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
N HALF OF
r
NO. INSPECTION FEE
S GREES To DEFEND AND HOLD HARMLESS THE CITY OF
u T 0
IN INTEREST. AGREES T
, �NDE.NIFY.
i EDMONDS, WASHINGTON. TSOFFICtALS. EMPLOYEES. AND AGENTS FROM ANY AND
�HNGT.N
A.AGES 0
xc. AULCI-AWS FOR DAMAGES OF WHATEVER NATUAE.ARISING DIFECTIOR INDIRECTLY
ISSUANCE OF THIS PERMIT SHALL NOT BE
ECEIPT
CHECK DEPOSIT
c FROM THE ISSUANCE OF THIS PERMIT.
I NCE OF T,
DEEMEDTOMODIFY, WAIVEOR REDUCE ANY REOUIREMENT OF ANY CITY ORDINANCE
, Y W IV I
PLAIN
W Y THE C INANCE PROVISION.'
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'_
I ClIPT
T TAL AMOUNT DUE
IHEPEHY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INF.F.A.Til.N
APPLICATION
APPROVAL
GIVEN I CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
Th,, ppl—t—I, M , Pil ��l 1.19— by Ih.
S RUC
THEOWN�A I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONST
CALL
30-g Oill—I .1 hllffiol P.1d.
O'Puty:
TION. AND IN DOING THE WORK AUTHORIZED THEREBY NO PERSON WILL BE EMPLOYED
OF WASHINGTON RELATING TO
FOR INSPECTION
,.—p- ,klollodgld m IP— PlIvid1d.
IN VIOLATION OF THE LABOR COPE OF THE STATE
WORKMEN �CONI INSOANCE AND FCW 18.21
0 DATE
OR A0VNT)'L DATE SIGNED
(425)
=Wt
771-0220
FELE��, IDATE
IPENT'ON
EXT 333
TO USE OR OCCUPY A BUILDING TRUCTURE UNTIL
I I U , 3 OR I
N
771-0221
-AWFUL
HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL-FLE YELLOW- INSPECTOR
A FINAL INSPECTION
CATE OF OCCUPANCY HAS BEEN GRANTED. LIBC SECTION 1 09
FAX
PINK -OWNER GOLD -ASSESSOR
HEATSOURCE
PLAN CHECK NO:
z
0
=i -
0
rn
rn C3
0
80
c
M
M z
r)
0 -n
n
Fn al
0-
0 ch
0 r-
m 0
Z
z
-q
m
rj)
z
0
i
0
m