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20000297.pdf__6ATE RECEIVED PERMIT EXPIRES USE CITY OF EDMONDS ZONE PERMIT ZOOZ)7 NUMBER CONSTRUCTION PERMIT APPLICATION JOB UITUAPTN ADDRESS f'— k OWNER NAMEINAME OF E�SINESS no PLAT NAMEISUBDIVISION NO. LA, V LOT lid. U FEES MAtLINGADDRESS -2 C "f� p ER OF' PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP H p U L R' C T OF WAY IS N EXISTING - PROPOSED E X T'C G P FOODS N_ REQUIRED DEDICATION- FT R E 0 R ED DEC'CATIO TEIIPAIII-11 0 R ... ........ 0 0 .A d 9. I p CITY ZIP TELEPHONE NAME T' E METES SIZE I V E R Z S' LINE SIZE, L IN SIZE N0,OFlIXTURll YPFV PEOUI RED _r . No 0 ADORE S TE A MARKS RE ARK M WNESOCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 0 0 Rl NT.A.T.. FECP.N WNE .0 ZIP ZIP ITILEPHON1 e NAME AM'ES�' 1) ENGINEERING FISVIEWEDMATE R ENGINES ING ADDRESS 17-- W b OARIAN.S qU 'TY CITY T=N�, OF ORCLINE OR ADS' INSPECTION SCO-D OYES ON01p, OSTED STATE LICENSE NUMBER �TAT L-E -0c, ' E All S p 'VIEW COMPLETE EXEMPT p EXP AREA AUQWEO I PROPOSED HEIGHT ALLOWED , PROPOSED ELL NO_102.:'7 - 0 y If -00 IROP511TYTAX ACCO 03' �; ()Vq 3z;? 7 — 03 RESIDENTIAL 0 P E NEW LUMSING/MECH HV LOT COVERAGE ALLOWED 'S. - ALL W PROPOSED REQUIRED SETBACKS IlT.1 FRONT SIDE REAR PROPOSEOSETBACKS(7) FRONT RSIDE REA R AN C 0 C 111INCE OR ADDITION 0--COMMERCIAL COANGE OF USE REMODEL APARTMENT 0 SIGN -RIVI-111 PARKING REO'D PROVIDED LOT AS 7NNING BY DATE -GRACING CYOS 0 PENCE 0 REPAIR X IT) DEMOLISH 0 THE TANK 1�5 0 `RAG_ 1-;ARPO4 0 RoETA',-j'lNy- WALL 0 RENEWAL TYPE OF USE, IUSIN ESS OR ACTIVITY) EXP N jC CHECKSDBY TYPE 0 DNS SUCTION v 15 9- NT COUP' 2 & NUMBER OF FT.PSCS N U, I .5 N D LU G UNITS OR TIlAl AS EAS NUMBER IPICI L NSPI T R A 11 1 D 13EOUIRE C3 YES JAREA O-CYPA HT LOLA, DESC ]BE WORK TO BE Dr/l REMARKS uMPrTInMA PER U.0 1081FINAL INSPECTION REO' VALUATION FEE I - z o q m m 00 io 0 c 4 r. mm m z g) -i 0 mm 0 o Fn 8 fn mw mo Z z i PLAN CHECK FEE u I HEAT SOUR GLAZING % LOT SLOPE % BUILDING 0 m VESTED DATE PLAN CHECK NO: PIL MBING C3 � I MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Ll BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION JOWITHE PUBLIC ILL REQUIRE MAROUEES,ETC� LLREQUIAE GRADINGIFILL 7 DOMAIN ICURBS, SIDEWALKS, DRIVEWAYS, SEPARATE PERMISSION. SURCHARGE PERMIT APPLICATION: 180 DAYS PERMIT LIMIT, I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS E EVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFOSMATION kSPECTION FEE -APPLICANT ON BEHALF F HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS . IN INTEREST, AGREES T :NDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF NDSCAP NO TS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND N SPECTION FEE DIRECTLY OR INDIRECTLY 5 PERMIT SHALL NOT BE PLAN CHECK DEPOSIT RECEII s OFANY ITYORDINANCE ORDINANCE PROVISION.' TOTAL AMOUNT DUE RECE17,�: 7 7 7 1 U AT I HAVE READ THIS APPLICATION; THAT T14E INFORMATION HA APPLICATION APPROVAL 1 HEREE OR THE DULY AUTHORIZED AGENT OF 0 1 VE N �y, =TL,AN.E IT. T I A. IN C -W N E P Th., OPP-— 11 h1t I , . j Ontil si.qhld by lhl THE O� INCH GREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC BE EMPLOYED CALL W, B,jId,hg 011-111 hi-11 DO h,I F Oh. 0. Od ND,�,,,A RSON WILL TION, A ING THE WORK AUTHORIZED THEREBY NO PC STATE OF WASHINGTON RELATING TO FOR INSPECTION ipt ,kh-lodgld P110 PrOv-dAd �CVIOLATION OF THEALTABOR CODE OF THE FKNIEN S COMPENS 'ON INSU CW 1821, jANCE A;�" OFF, 11 a E E DATE SIGNED (425) ou E 0 771-0220 BY DATE REL T N 71EFLETO EXT 333 /z_ LILT 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 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ............... FOUNDATION: Footing ...................... Wall ........ ....... Pier/Porch ................. Retainlrig Wall ........... Slab insulation .......... PLUMBING: Underground M C 'Rouah-In M C, ........... 0 -4 0! U" n�, t commercial Final x M HEATING: M z 10-1 I Z, Gas Test .................... > r - —I 3: Gas Piping ................. ,Equipment ... ........ 0 -W Commercial Final rn T, EXTERIOR SHEATHING NAILING .......... C) F; FRAMING ............... rn 0 FIRST FLOOR FRAMING. - I NSULATION ........... Floor Insulation Z Wall Insulation ........... Ceiling Insulation Z, SHEETROCK NAIL ING 0 SPECIAL: INSPECTION M MISCELLANEOUS FINAL APPROVAL FOR OCCUPANC y .................. �, av, �,, I", PERMIT EXPIRES PERMIT ZOO 7,� ZONE —29 CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITEMPTO ADDRESS OWNER NAMENAME 01 ,13 Io i7SINEIS PLAT NAMEISU801VISION NO. LOT l4d. irc, LL�DD FEE S MAILINGADDRE ;� , HY 147 PUBLIC RIGHT OF WAY PER OFFIOAL STREET Al - =%.�e 0 0 0 'NAME CITY )ZO ITE11PIll EXIS ING - PROPOSED- REQUIRED DEDICATION- FT ETER SIZE LINE SIZE NO, 01 FIXTURES 0 IFV FIEDUIRED I es 0 NO 0 iE ADDRESS MARKS OVINFRfOONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE NA � � T ENG'NE77 REVIEW501DATE ADDRESS F E W D E CITY TELEPHO E VARIANCE VARIANCE Or" eALL.D rORELINE OR ADS# INSPECTION H'a. OYES [3NO ..No POSTED STATE LICENSE NUMB R -1--ON DATE T HODD F-9-0 L I 'H SEPA IEW C.MPLETE -�-XEMPT COMPLETE EXEMPT EXP EX -SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED , PROPOSED PROPERTY TAX ACCOUNT PARCEL NO,5 3,) (3 S D E -NT` E] RESIDENTIAL PLUMBING/MECH LOT COVERAGE L.T..V RAGE WE F.P..E. ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SET KS (FT.) FRONT URSISDAECSEAR 'AL 0 ADDITION 0--COMMERCIAL E] COMPLIANO OR j I COMMER. AL CHANGE OF USE [0 ApAl' �TMENT E] REMODEL C] APARTMENT SIGN PARKING REaD I PROVIDEDP7 L DATE ENCE f-1 REPAIR GRADING CYGE PENCE I X FT) x __ REMARKS A K_ M R S THE n DEMOLISH 0 TANK 0 As W C A C3 III 13 GARPGFT 'lTAKl0INyG WALL RENE AL Do F, 0 +FTRE CHECKED By PE yONjrRUCTI.0 r C UPA T soup A NUMBER OF STORIES OF DWELUNG- UNITS TAS A I 11CAL V_ AREAS �E _ I NUMBER SPEOALINSPECTOR JAReA REOU REQUIRED [3 YES Lo I REM R S ISMARKS NIS PER LED 1081FINAL 111�01e'Td S r..". VALUATION PLAN CHECK FEE HEAT SOURCE .-IIN. LOT .-PE B PLAN CHECK NO: ... PLUMBING MECHANICAL 1p! THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THI IiUCTO. U.L I BE DONE ON PRIVATE PROPERTY ONLY. ANY CONIST -==--wozK GRADINGIFILL 9 DOMAIN ICURSS, SIDEWALKS, DRIVEWAY , MARQUEES, ETC.) WILL REQUIRE :31 SEPARATE PERMISSION. LI PERMIT APPLICATION: 180DAYS PERMITLIMIT.-I YEAR - PROVIDED WORK IS STARTED WITHIN 180OAYS 9NG. REVIEW FEES SEEBACK F PINK PERMIT FOR MORE INFORMATION ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS .1 SPECTION FEE ;APPLICANT. N INTEREST, AGREES TO �NDEMWFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING M EDMONDS, WASHINGTON, TS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND A C ROAMAGESOFWHATEVER NATURE,ARISING DTECTLYOR INDIRECTLY I LAIMSFO PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE INSPECTION FEE DEPOSIT RECEiP FROM THE ISSUANCE OF THIS DEEMEDTOMODIy F AlYlffY011INAll� PLAN CHECK W�y�TAIVECIIY%E�l�lIEAIY21111RIIINTI NOR LIMIT IN ANY E UTY To ENFORCE ANYORDINANCE PROVISION. TOTAL AMOUNT 0 I HEREBY ACKNOWLEDGE THAT: IfAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT. AND THAT AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF Thie 11 u-I - Puletil tutuil �19 el 1�- THE OWNER. tAGRE' TO COMPLY WITH CITY AND STATE LAWS FE.UITING C.NST8UC- CALL _g tuoher Deputy: Ild F ,, ,P. ,d TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION eP, i,I u.wt.dg.d �e el- P1.11d.e. IOLATION OF THE LABOR R'KMEN'B COMPENSATION INSKANCE A 18.27� _p.V . OFF 11 SIG RE ,,NBffW DATE SIGNED (4 tGNATU (OW OR c RE DRY DATE �33 'T N FlITLAY6 UA Z_1 C) 0 17T uT USE OR OCCUPY A BUILDING OR STRUCTURE 771-0221 INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI- ORIGINAL FILE YELLOW - INSPECT R A FINAL CATE OF OCCUPANCY HAS BEEN GRANTED, LED SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR