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20000243.pdf.N `I DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION iY/. vvt [/9�lIV NAME ADDRESS a CITY ZIP NAME S ADDRESS It Z [PERMIT EXPIRES USE PERMIT ZONE , NUMBER 2aaa(;/- JOB n SURE/APT' ADDRESS `( �7 GGG 1 ,_ O tt. PLAT NAMEISUBDIVISION NO. LOT NO, LID N0. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP App'— qW P° oimmn geea EXISTING PROPOSED — REQUIRED DEDICATION FT METER SIZE LINE SIZE NO.OF FIXTURES PRV REQUIRED ES U NO RWNu=oKf nuiRACTOR RESPONSIBLE FOR EROSION CONTflOUDRAINAGE /Wo 64- 5 5 "&. FIRE REVIEWED BY DATE :ITY ZIP TELEPHONE ✓♦'✓T ` I/ 1;0^�- /� VARIANCE OR CU SHORELINE OR ADBp INSPECTION BOND 3 ATE LIC NSE NUMBER EXPIRATION DATE CHECKED BV - ES POSTED YES ❑ NO © / 6 ��//11�� - ca0 VI SERA REVIEW - SIGN AREA HEIGHT ROPERttTYII TAX ACCOUNT PARCEL NO. - COMPLETE'I EXEMPT ALLOWED I PROPOSED ALLOWED PROPOSE. EXP ,. LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.) FRONT SIDE REAR ''FRONT- UR SIDE REAR ❑ NEW RESIDENTIAL ❑ PLUMBING I MECH ALLOWED PROPOSED AUDITION ❑ COMMERCIAL ❑ CHANGE OF USE Z PARKING LOT AREA PLANNING REVIEWED BY GATE i ❑ REMODEL ❑ APARTMENT ❑ SIGN REO'0 PROVIDED ❑ REPAIR ❑ GRADING CYDS ❑ `ENCE X _ FT) FT) REMARKS ❑ DEMOLISH ❑ TANK OTHFj[�._,_ < ❑ GARAGECARPORT ❑ RETAINING WALL - ❑ RENEWAL (TYPE OF USE, BUSINESS OR ACTIVITY)EXPLAIN: CHECKED BY TYPE OF CONSTRUCTION CO —V&r... GROUP GROUP NUMBER NUMBER OF CRITICALA AREAS INSPECTOR ARREEA1(-. OCCUPANT SR LOAD OF DWELLING NUMBER 7 REQUIRED ❑ VES STORIES UNITS DESCRIBE WORK TO BE DONE REMARKS 1 PROGRESS INSPECTIONS PER UBC 108/1FINAL INSPECTION REQ'D i _ VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING % LOT SLOPE % BUILDING PLAN CHECK O: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WGFIK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE RO ERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETD.) WILL REQUIRE SEPARATE PERMISSION.EdiiKESUR GRADINGIFILL �//IIq�I HARGE i PERMIT APPLICATION: 180 DAYB PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION END. REVIEW FEES 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS ENG. INSPECTION FEE IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING IS EOMONDS,WASHINGTON, ITSOFFICIALS,EMPLOYEES, AND AGENTS FROM ANYAND INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY i FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE pLAN CHECK DEPOSIT e DEEMEDTOMODIFY, WAIVEOR REDUCE ANY REOUIREMENTOF ANY CITY ORDINANCE iNOR LIMIT IN ANY WAYTHE CITY'SABILITY TO ENFORCE ANYORDINANCE PROVISION.' TOTAL AMOUNT DUE _ RECEIPT RECEIPT r I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR TILE DULY AU THORI2ED AGENT OF THE OWNER. AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- 'TION;ANDIN DOING THE WORK AUTHORIZED THEREBY. ND PSWILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHING70N RELATING TO WORKMEN'S COMPENSATION INSURANCEAND RCW I8.27. DATE SIGNED 3 -dckA) SIGN E(=UL APPLICATION APPROVAL CALL ydiAy II'Ici. pr HisIh., D°p°ly: end Foos a l plld. and FOR INSPECTION ocop °wl°dB°d ip sp.co prcvidpd. OFFICIALS SI DATE (4GS>n �/ 771-0220 HEL SEDBY DA E ATTENTION EXT 333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OF1A CERTIFI- FAX CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 ORIGINAL PIN`OWNER GOLD ASSESSOR INSPECTOR BIBS f-- s RECORD OF INSPECTIONS , rs - -INSPECTOR DATE APPROVED >. SETBACKS......... UNDATION pq Footing ...................... Z Wall -.... -... O .... — I I, m,r f s hr ' Pier/Porch .............. .. i` i Retainirig Wall kh ulation .... ...... Jt, '.' . PLUMIBING ,. - m O o nl - SGS'�r Undergrountl .. ........ rk Rough -In _ rn Z, ' - Commercial Final..... CD Z r_1 � 'HEATING: - . � t0 ` i fn• .' .'. ..... Gas Test O Gas Pi ping .. .... .. S C rV m IT Equipment .... p �. O k'* �' Commercial Final .[. C F - .. 9 .. EXTERIOR SHEATHING 20 r_I' - NAILING. FRAMING........................ FIRST FLOOR FRAMING... Z. • INSULATION ................... fit. 9 .. Floor Insulation ......... .. _. Wall Insulation ...'........ O.. l{ Ceiling Insulation ..... _ O m . SHEETROCK NAILING .... .. �;_ ��- SPECIAL INSPECTION .... - - MISCELLANEOUS............ ' FINAL APPROVAL FOR �;�•��'`. �7 ( + �O — --.�. ��;. .00CUPANCY ...... ... ....... / �.. - 1 J - .• 'DATEPECEIVED��t �' ` i.OFPERMIT EVIRES "' t USE _ PERMIT CITY OF EDMONDS �I ZOBE z NUMBER BOITEAPrx CONSTRUCTION PERMIT APPLICATION ADDREss OWNER AMEMAME FBUSINESS .., PLAT NAMEISUBDIVISION NO, LOT NO.. LID NO. c_ -. /J • C" Ye e LID FEE$ 4 i a MAILINGA D ESS TEscP -pp—ea ❑ /K- PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RVl;e R.que.e ^ ❑ �' EXISTING PROPOSED nP.1-d ❑ CITY ZI TELEPHONE e.... Regeoea ❑ �. � REQUIRED DEDICATION FT weft' Rune O / i7 VJ yrequxed Z^1 METER SIZE LINE SIZE NO.OF FIXTURES PRV REQUIRED O NAME YES ❑ NO ❑ - ADDRESS REMARKS - - OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/ORAINAGE x CITY ZIP TELEPHONE NAME vvillill min a low fy^ ENGINEERING REVIEWEDIDATE- . ADDR.E^SSh ` S c/ J DATE ✓ `� r BY Z o FIRE REVIEWED CITY 21P TELEPHONE m Gvv4-VARIANC�.ORCU SHORELINE OR ADBq INSPECTION BOND $ ATE LIC( EE NUMBER EXPIRATION DATE CHECKED BY ) REO'0 POSTEDONO T SERA REVIEW SIGN AREA HEIGHT (n� Q PROPERTY TAX ACCOUNT PARCEL NO. - COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED C m w V EXP I� J mio (�o' O x�. r LOT COVERAGE REQUIRED SETBACKS(FT.). PROPOSEOSETBACKS(FT.) ❑ NEW PRESIDENTIAL ❑ PLUMBING /MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR COMPLIANCE OR I 21, AUDITION ❑ COMMERCIAL ❑ CHANGE OF USE m ; mZ.. PARKIN G LOT AREA PLANNING REVIEWED BY DATE a " A �•{ n" ❑ REMODEL ❑ APARTMENT ❑ SIGN REO'D PROVIDED ^^.-.•- •--..Ax...,., �•.y' D Z '. \ GRADING FENCE REMARKS X FT) ❑ REPAIR ❑ CYDS❑.T l r S r- ❑ DEMOLISH ❑ TANK tLl QT 42 O0 T 1 ,❑ j GARAGE RETAINING WALL RENEWAL - Z ❑ CARPOflT ❑ S m F (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CHECKED BY TYPE OF CONSTRUCTION CO OCCUPAN GROUP m 1' 0 N 7 I J O NUMBER OF w NUMBER O GP DWELLING O STOP UNITS CRITICAL AREAS (]j Ste`• NUMBER I ^`^-' SPECIAL INSPECTOR AREA OCCUPANT LOAD REQUIRED ❑ YES O o Fn C Tn m Z 1 DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO D 1 d z. x Z. VALUATION FEE 0 -� PLAN CHECK FEE. n m HEAT SOURCE GLAZING % LOT SLOPE % BUILDING ((yyam� S' Jt.1 PLAN CHECK O� VESTED DATE PLUMBING f MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE i ~ SEPARATE PERMISSION. GRADINGIFILL R HARGE a PERMITAPPLICATION: ISO DAYS PERMIT LIMIT. I YEAR. PROVIDED WORK IS STARTED WITHIN ISO DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION ENG. REVIEW FEES I' '^ •APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS w IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF Z EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND a ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY S FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE O DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE i NORLIMIT INANYWAYTHE CITY'SABILITYTO ENFORCE ANYORDINANCE PROVISION.- ENO, INSPECTION FEE LANDSCAPING INSPECTION FEE PLAN CHECK DEPOSIT TOTAL AMOUNT DUE RECEIPT RECEIPT ) .J V I HERESY ACKNOWLEDGE THAT:HAVE. READ THIS APPLICATION: THAT THE INFORMATION GIVEN IB CORRECT. AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. 1 AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- 1 TION: AND IN DOING THE WORK AUTHORIZED THEREBY NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW tS.PT. j SIGN T E(OWNERO A NT DATTE SIGNED �.A1 ±'� 3 _ / —✓' �'�L� I APPLICATION APPROVAL This opplice ion is nPl a polmit unlll siORatl by Iha CALL 0tl' Wey� hls)hee D pp i e O Fees are paid, end i p N.1 , D,ptl y: space prav,,, p FOR INSPECTION !r p e. /� OFFICIALS SI 1 T \ DATE / (425) / 71 -O"O 'REL SED BY DATE _ ATTENTION EXT 333 IT IS UNLAWFUL TO USE OR OCCUPY ABUILDING 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 ORIGINAL FILE YELLOW � INSPECTOR PINK - OWNER GOLD - ASSESSOR I $/90 I