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20000309.pdf:=—) PERMIT EXPIRES USE PERMIT - CITY OF EDMONDS 2-0 10NE NUMBER C),;QI?..._ CONSTRUCTION PERMIT APPLICATION 'A'DDRE- __ T' 0 OWNER NAMONAME OF BUSINESS PLAT NAMEISUBDIVISION NO. Ldf NO. I LID NO, LID FEE $ / w MAILING ADDRESS PUBLIC RIGHT .1 PER OFFICIAL STREET MAP EXISTING — PROPOSED TE C.P'App—d 0 "Sp 0 ._'_ 11 Iql 0 0 0 CITY 21P TELEPHONE REQUIRED DEDICATION— FT NAME METER SIZE LINE SIZE PAV REQUIRED I YES 0 NO 0 ADDRESS REMARKS A, OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGS CITY 21P TELEPHONE NAM REVIEWEDIDATE ADDRESS 0 "d:? c:? a- eq FIRE REVIEWED BY DATE tl CITY ZIP TELEPHONE STATE LICENSE NUMBER EX VARIANCE OF CU SHORELINE OR A..' INSPECTION fE9110 7-nNR' _�NZ e12 �111�_±2_11k_'� 0 YES 0 NO SERA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. EXP I , , LOTCOVERAGS REQUIRED SETBACKS (FT) PROPOSED SETBACKS (IFE) C3 NEW RESIDENTIAL PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT US SIDE REAR C] ADDITION 0 COMMERCIAL C MPLIANGEOR 10 CHANGE OF USE PARKING REO'D PROVIDED❑ I LOT AREA PLANNING REVIEWED BY DATE D 0 REMO EL C] APARTMENT ❑ SIGN 0 GRADING CYDS❑ FENCE REPAIR ( x FT) — REMARKS C] DEMOLISH * TANK --4)aCAh-❑ OTHER o GARAGE 0 1R1�1�TAIININ�G WALL ❑ RENEWAL CARPORT p (TYPE OF USE, BUSINESS On ACTIVITY) EXPLAIN: e.CHECKEDBY TION OCCUPANT S7� - ITYP SOUP I NUMBER O 0 F NUMBER DWELLINGOF 1 In AL CRITICAL ' AREAS SPECIALINSPECTOR OCCUPANT 0. STORIES UNITS NUMBER REQUIRED 0 YES JAREA LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC JOB/FINAL INSPECTION REO'D 9 VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING % LOT SLOPE % BUILDING PLAN CHECK NO: IVESTIO DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE GRADING/FILL SEPARATE PERMISSION, Q S RCHARGE PERMITAPILICATI .: 'S..AYS A. PERMIT LIMIT, I YEAR . PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AN. SUCCESORS ENG. INSPECTION FEE IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING 2 EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND INSPECTION FEE QM ALL CLAIMS FOR DAMAGESOF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY RECEIPT FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SMALL NOT BE PLAN CHECK DEPOSIT 'Y WAIVE OR REOU E ANY REQUIREMENT OF ANY CITY ORDINANCE Y� ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' =TTOIN`ANDW�YTHECIT BASIC RECEIPT TOTALTOTAL AMOUNT DUE �5 _Vy I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC TIb,s application is npla P.—I -,I s,U by tho CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED 8uil L, OM-1 or h—.1 D.puly: — F .. IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION b,l is acknpwlptlgptl in apaco p—l-d. WORKMEN'S COMPENSATION INSURANCE AND RCW 18,27. ATE OFFICIAL ON USE DATE E SIGNED (425) 771 1 —1-0 RKEASED BY DATE ATTENTION z EXT 333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 1 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL. OR A CERTIFI- ORIGINAL. FILE - YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 FAX PINK - OWNER - GOLD -ASSESSOR J /- GRANf FINAL PROJECT APPROVAL >. _-GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED 1. __FAILED FINAL INSPECTION - OUTSTANDING ISSUES 1. 2. 3. REINSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL ocaptvl.doc.l:tomp:bldg:fo-6l98 z O 4 0 m cm m0 iO OC -49 m z A-4 Dz r_ -i O-n mm_ oor �in �r A M x z z s 0 z 0 0 m RECORD OF INSPECTIONS ; INSPECTOR DATE APPROVED ; SETBACKS :. ..... - a FOUNDATION: i' +, Footing ............ a Wall ................. ..,. . Pier/Porch ......... Retaining Wall ........ Q rn Slab Insulation .......... . .. .PLUMBING: .. <Om !a Underground ............. ..., m .. h t Rough -in ......... ... _i OC ' " 1� Commercial Final ...... IT, HEATING: Gas Test .................... r Gas Piping - to ... Equipment ... O -{ 2 3A~ Commercial Final .....:. m m I fit. . .EXTERIOR SHEATHING ' NAILING ........ ..... C FRAMING:. ....... _. •: Zrrn =z .... FIRST FLOOR FRAMING... D �� , ;U ' INSULATION ........ "='{ ' ;.. ` Floor insulation ......... . ,.. ,,. Z >: . _. Wall Insulation .... ...... fA. ' i Ceiling insulation ........ Z SHEETROCK NAILING .. O ro i SPECIAL INSPECTION MISCELLANEOUS..........- . - :FINAL APPROVAL FOR I OCCUPANCY ................ .. :..... I y R DATE RECEIVED I CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION MAILING ADDRESS �/7 ADOAESS CITY _ ZIP TELEPHONE q PROPERTY TAX ACCOUNT PAHDELNG. wJ J 9L — ❑ NEW 'jp.RESIDENTIAL ❑ PLUMBING/MACH ❑ ADDITION COMPLIANCE A ❑ COMMERCIAL ❑ CHANGE OF USE ❑ REMODEL ❑ APARTMENT ❑ SIGN ❑ REPAIR FENCE GRADING CYDS ❑ { �_ % FT) ]❑ ❑ DEMOLISH ,I.("j' TANK _-Z. . ❑ OTHER /T GARAGE z ❑ CARPORT RETAINING ❑ RD K RY WALL ❑ RENEWAL -- 0 F (TYPE OF US�SINESS OR ACTIVITY) EXPLAIN: w NUMBER NUMDER OF CRITIC AL AREAS pP o STORIES DWELLING / UNITS •„�•� NUMBER DESCRIBE WORK TO BE DONE PE _` a t�f�} RMIT EXPIRES 4 _L L_ sE j PERMIT ZONE Ks _ / .2, NUMBER 0 JOB /• >> „SUITE/APTa ADDRESS (, L... U L kc(") 4;>9 PLAT NAMEISUBDIVISION NO. I L NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING PROPOSED week Ragvi,ae p REOUI RED DEDICATION FT WI�jnd 0 METER SIZE LINE SIZE NO.OF FIXTURES PRV REQUIRED YES D NO O r Z _ - , 0 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDPAINAGE ENGINEERING .Df FIRE REVIEWED BY DATE 1 n !!I VARIANCE OR CU SHORELINE OR ADBF INSPECTION flE0'D BOND POSTED AYES ONO SE PAREVIEW COMPLETE EXEMPT' SIGN AREA ALLOWED- PROPOSED HEIGHT ALLOWED PROPOSED EXP ( O I11 iC11� 0 LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACK$ JFT.) FRONT SIDE REAR PROPOSED SETBACKS (FT.) FRONT URSIDE REAR 2 S OC iR1 PARKING LOTAREA PLANNINGREVIEWEDBY DATE PlaD PROVIDED RI z I Z 'o O i D Z - m O y C c m (p O REMARKS CHECKEDBY TYPEOF ONSTREION COQ,E OCCUPANT ( GROUPrn SPECIAL INSPECTOR REQUIRED ❑ YES AREA OCCUPANT LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D S J / VALUATION FEE 0) ': Z O m PLAN CHECK FEE HEAT SOVRCE GLAZING % LOT SLOPE% BUILDING - PLAN CHECK NO: JVESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ONTHE PUBLIC GRADINGIFIL DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.)WILL REOUIflE SEPARATE PERMISSION. t SU CHARGE �j I/'..' PERMIT APPLICATION: 180 DAYS .� PERMIT LIMIM I YEAR • PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG, REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION ! �. (. ENG. INSPECTION FEE •APPLICANT.ONBEHALF OFHIS HER SPOUSE, HEIRS, ASSIGNS ANDSUCC I F FY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING IN INTEREST, AGREES TO INDEMNIFY. EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND INDIRECTLY INSPECTION FEE 1 ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLYOR THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT RECEIPT FROM DEEMED TOMODIFY, WAIVE OR REDUCE ANY REOUIREMENT OF ANYCITY ORDINANCE > NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANYORDINANCE PROVISION.' -I TOTAL AMOUNT DUE RECEIPT Sz ( tt�,a�� +.} / �V HEREBY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT i AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF AND STATE LAWS REGULATING CONSTRUG CALL The, application is not a permit until signed by the Foos antl THE OWNER. I AGREE TO COMPLY WITH CITY WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Builtlie 011iciat or his/her Deputy: and 11, pied. S in apace provitlotl. TION: AND IN DOING THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION eoceipl is acknpwlotlgptl -�•�.` IN VIOLATION OF THE WORKMEN'S COMPENSATION INSURANCE AND RCW 18.2I. OFFICIAL IGN URE /D/ATE - SIGNAT 0 1 DATE SIGN D (425) �y 7 l� t /'� 771-0220 •,.�_,�I q EASED BY DATE 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 OR A CERTIFI- ORIGINAL FILE YELLOW• INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK OWNER GOLD- ASSESSOR