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20000329.pdfDATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION 3 CITY IIP JTILEPHC LA rs NAME m PERMIT EXPIRES us PERMIT ZONE NUMBER Z eojD37-a 'OB Jq ADDRESS UITV�PTN PLATNAME/SUBIXVISI.NN.. I IOTIO. LI NO. LID FEES PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP P*l 11 1111d EXISTING — PROPOSED — Id REQUIRED DEDJCATION� FT — u—g—1 METER SIZE LINE.SIlE 10, OF FIXTURES PRV REQUIRED I 1 YES C3 No 13 REMARKS —NERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE L& ' ' ADDRESS 6L471-- yl/g/eaD FIR REVIEWED BY DATE CITY ZIP c TELEPHONE VARIANCE On CU SHORELINE OR ADBN INSPECTION REQ.G 0 YES 0 No BOND POSTED I !RATE LICENSE NUMBER EXPIRATION DATE CHECKEDBY SERA REVIEW COMPLETE EXEMPT I SIGN AREA ALLOWED PROPOSED I HEIGHT ALLOWED I PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. Exp - - NEW RESIDENTIAL PLUMBING f MECH LOT COVERAGE ALLOWED PROPOSED ED SETBACKS (FT.) 'W FRON�- E��" PROPOSED SETBACKS (FT.) FRONT UPSIDE REAR E3 ADDITION COMMERCIAL o COMPLIANCEOR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE 0 REMODEL Cj APARTMENT [3 SIGN REGO PROVIDED FEN REPAIR GRADING CYDS X� , !T REMAHK5 DEMOLISH 0 TANK o OTHER Jet ou, Vt 177 RETAINING WALL GARAGE ROCKERY C]. RENEWAL Z CARPORT 03 �PLAIN: 0 (TYPE OF USE. BUSINESS OR,�gr)f CHECKED BY T :;oll CON VCTION I el- i"f 1COtWOC CUPANT GFGtjP NUMBER OF STORIES NUMB EROF DWELLING UNITS I RITICAL AR S NINUE 411141 I E ECIALINSPECTOR JAREA REQUIRED 0 YES NT LOAD DESCRIBE WqIRK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RECl' 6ao- &4 c Y- 3ZO I Ao 4MA4 / f- ISS11 "q VALUATION I FEE PLAN CHECK FEE HEAT SOURCE GLAZING LOT SLOPE % BUILDING PLANCHECKNO: W_(UGI IVESTEDDATE PLLMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRA.INGIIILL DOMAIN 4CURBS. SIDEWALKS. DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. �TAT PERMIT APPLICATI N: 180 DAYS PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS N.. FE.EW FEES SEE BACK OF PINK PER MATiON 'APPLICANT, ON BEHALF OF HIS On HER SPOUSE. HEIRS. ASSIG NS S ES ENG. INSPECTION FEE IN INTEREST. AGREES TO 'NO EMNIFY, DEFEND AND HOLD HA L T E ITY F E F EDMONDS, WASHINGTON, ITS 0 FICIALS ,EMPLOYEES�ANDA N A YANG 41,19peeT+914� I ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING Dil E T NDI E TLY NOT BE RECEIPT FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL DEEMEDTO MODIFY, WAIVE OR REDUCE ANY REQUI REM ENT I ITI —INANCE PLAN CHECK DEPOSIT NOR LIMIT I N ANY WAY THE CITY'S ABI LITY TO EN FORCE ANY ORDINANCE PROVISION.- TOTAL AMOUNT DUE RECEIPT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVE. IS COR ECT, AND THAT I AM THE OWNER OR THE DULY AUTHORIZED AGENT OF R Th. t . 61 19— by - 6 STATE LAWS REGULATING CONST - THE OW NER I AGREE TO COMPLY WITH CITY AN RUC CALL B111dimg Official 11 hlllhll DIP ty; Ild FIll a,e 0.1d. -d u TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION RELATING TO ipt iI ckn,lildgld j, pace pmvldod. FOR INSPECTION OF THE LAB. P CODE OF THE STATE OF WASHINGTON WORKMEN'S COMPENSATION INSURANCE AND PCW 18.27. — OFFI AILS SIONATURE SIGNAT, URE (OWNER OR AGENTI D AT (425) 0/00 771-0220 ELEASW By ATTENTION EXT 333 ITS UNLAWFULTOUSE OR OCCUPY A BUILDING ORSTRUCTURE UNTI 771 -0221 —INSPECTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIF - ORIGINAL FILE YELLOW CATECF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK-OWINER GOLD -ASSESSOR 5198 z 9 1 1-.. 0 om c m 0 80 c: —4 C = M M z JO--I C o -n n -4 X rn m a 0 o a ch A z co z 9 0 IT! MIN -1 BUILD TV OR bo m — W. 7 .2'QQQ. OEVELOPMI�" S'O ..... 11W ng M. 7mni C:m a jk "K. RECORD OF INSPECTIONS c INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing .... .. ............. wall ................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground, ............. Rough -in ................... Commercial Final HEATING: Gas Test ............ Gas Piping ................. Equipment ................. Commercial Final EXTERIOR SHEATHING, NAILING .......................... FRAMING........................ FIRST FLOOR FRAMING INSULATION ................. Floor Insulation Wall Insulation ........... Ceiling Insulation SHEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL-11111111111101, .................. C/o (i� '17k . 0. co am C MO x M In 10 0 n -n M M 0 0 C 0) M 0 Z z C9 Z 01 M PERMIT EXPIRES us. PERMIT ZONE CITY OF EDMONDS US NUMBER 'o JOB SUIT LICATION CONSTRUCTION PERMIT APP71�ODRESS E OF BUSINESS LOT NO. I'D NO. S PLAT NAMEISUBDIVISION NO. LID EE S m MAILING ADDRESS TESL 0 1 P AIY P:ANpI.d ic, Q- PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP U'.1 pl.xul: R,,<. 10, EXIST G PROPOSED ft,ul- 0 CITY ZIP JTELEI ONE u --% 10 4 �S _r? *� 9 _S 'I 0<1 ss , 0- IR � (- NAME� Iliii�mo ADDRESS REMARKS OWNERICONT—WR EROSION CONTROLIDRAINAGE JkLi -o Fp- CITY ZIP TELEPHONE NOW A.' ENGINEERING 'E DIDATE 710 ADDRESS FIRE REVIEWED By DATE z CITY ZIP TELEPHONE 0 VARIANCE OR CU SHORELINE OR ADBR INSPECTION CI YRE O'D El I J'SOND OSTED -TTATE LICENSE NUMBER EX SEPA RE IE C MPLETE E EMIT SIGN AREA �LLOWED PROPOSED HEIGHT ALLOWED PROPOSED PARCEL NO. PROPERTY TAX ACCOUNT E P I vi a m I= LOT COVERAGE REQUIRED SETBACKS (Fn PROPOS90 SETBACKS FT1 NEW ElPLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT UPSIDE REAR m C MPLIANCE OR 0 ADDITION CHANGE OF USE 0 c PAR IN LOTARSA PINNING REVIEWEDBY DATE P. REMODEL SIGN REC', I P VIDEO I REPAIR GRADING Cy. P�!!L X ��T) A JO MARKS ra- vioLmni-Icnie 77-/Ilflfi E] DEMOLISH OTHER E] TANK oGARAGE C] RETAKININDWALL RENEWAL CARPORT ROC �R C] om -n m m m (TYPE OF USE, BUSINESS OR�A�VKLAIN CHECKED By TYP CON T UCT ON Cob OCCUPANT GROUP NUMBER OF CRIRCAL SPECIAL INSPECTOR AREA OCCUPANT OF / DWELLING I AREA NUMBSLqA* 5R REGUIR EQt] 0 STORIES DESCRIBE WqFAK TO BE DONE UNITS , , 0 In REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL SPECTION REWD a C: cl) I .S 17tU X 3 2 D ,IN PA/9 e1014- m (a rn 0 � r- z VALUATION FEE Pi -AN CHECK �.EF z HEAT SOURCE LOT SLOPE % BUILDING 9 0 PLAN CHECK NO: PLUMBING m _�r MECHANICAL AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE GRADINGIFILL SEPARATE PERMISSION. STATE SURCHARGE PERMIT APPLICATION: 180 DAYS PERMIT LIMIT'. I AR . PnovIDED WORK IS STARTED INITHIN 180 DAYS YE ENG: REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION A PUICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. A SSIGNS AND SUCjCESORS HARMLESS THE:CITY .7 ENG. INSPECTION FEE N INTEREST, AGREES TO :NDEMNIFY. DEFEND AND HOLD TS DFFICIALS� EMPLOYEES, AND AGENTS FROM ANYAND 2 EoMONDS,WASHINaTON. ALLCI-Al INGDIRECTLYORIN IRECTLY MS FOR DAMAGES OF WHATEVER NATURE,ARIS RECEIPT P I FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS EAMIT $HALL NOT BE PLAN CHECK D POSIT DEEMED To MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE TO ENFORCE ANY ORDINANCE PROVISION.- RECEIPT NOR LIMIT IN ANY W.Ay THE CITY'S ABILITY TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE HEAD THIS APPLICATION. THAT THE INFORMATI N APPLICATION,�,P 0 AL GIVEN OWNER. OR THE DULY AUTHORIZED AGENT OF - CORRECT; AND THAT I A. THE T I, NER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING OONSTRUC THE oWS Loy o EMP E CALL oll,j ., Nw— D F_ B." DING THE WORK AUTHORIZED THEREBY. N BE TION, A 0 PERSON WILL WASHINGTON RELATING TO FOR INSPECTION IN VIONDIN LATION OF TPE LABOR CODE OF THE STATE OF WORK MEN S COMPENSATION INSURANCE AND ROW 1827. OFFIC LSS$ AT IRE E SIGNATURE (OWNER OR AGENT) DATE SIGPJED (425) 7 -0220 DATf 71 ELEAS By EXT 333 ATTENTION IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CEFITIFI- ORIGINAL PILE YELLOW INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 09 FAX PINK OWNER GOLD -ASSESSOR SIDE —