20000344.pdfVVii,(At \
—7 pllll�
PoJrr, HzLAw— DATE RECEIVED
S
PERMIT 2_003q4
CITY OF EDMONDS
c (a
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB
ADORESS2 -'50()5
B ITEJAPTI
(iLl-k
OWNERNAMEINA EOFSUSINESS
LLI�_
PLAT NAMVSUBDIVIStON NO.
LOT NO. LID NO.
I LID FEE
MAILING ADDRESS
u
So�('
PUBLIC RIG HT OF WAY PER OFFICIAL STREET MAP WW;.1nat Rana, a 0
""a and 0
EXISTING — PROPOSED— .,,.,.a 0
CITY "P ITELEPHONI
mept,a,,)k qefo*;Cl
REOLPREDUEDICATION—
P.—
FT
�. IIE..MeD
NAME
I tjc—.
ETER S17E__7��
YES 0
ADDRESS
wc-
—MARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 8
JT�USPII.N�
CITY�a. kqC
NAME
INEERING
DURESS
S.-u
FIRE FIEVISWE.SY
"A"
it; 7TY ZIP _I TfiLEPHONE
M
NUMBSIA
",A Agnn sz�
Z-gj umo
juol
ILA-
�o
I �o
I
PROPEArYTAX ACCOUNT PARCEL NO.
57( , T-000-0 Ilt— 1004-
El RESIDENTIAL
0 PLUMBING f MECH
(3 ADDITION
>'ODOMIAERCIAL
o C PLIANCE OR
.0HANGE
0 REMODEL
APARTMENT
0 SIGN
g L.,
0 REPAIR YqS
F NICE
0 ( _X_FT)
C] DEMOLISH TANK
OTHER
GARAGE R IN.' WALL
ARPORT
REN—
r� OYE6 ONO I
SIGN AREA HEIGHT
ALLOWED PROPOSED ALLOWED , PIOPOIEO
p I
LOT COVERAGE REQUIRED SETBAOKS IFT.) PROPOSED SETBACKS (FT1
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
I —ARIP
PARKING
RE D I PROVIDED
CHECKEDBY TY5r%Ol7CON9[RUCTl;4 IQ -1-1—
(cs ILL GROUP
NUMBER N MDER OF p 1; UK;� SpECIJAL INSPECTOR AREA OCCUPANT
OF DWELL NG AR UU — LOAD
STORIES UNITS NUMBER REQUIRED rl YES
DESCRIBE WORK TO BE DONE ISC(14.1 EMARKS
L R
P GRESS INSPECTIONS PER UBC 1081FINAL INSPECT10h
RO
MhTe�j'kL fq," ")hcelr
le�xqel- aelvv /bbdoya 41+-, 1&1�
.9
?f.,I CIIA"T"IN " / 4 Aletv
R11 m wthe-&-p-nomd 9,f
.ter -rt exceev 5.6q,9 cY pcI;-, ?(A4- I 4'Jj A,#.4jh,4 mmg'�-Ae IS_<b
T.1
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE 'A LOT SLOPE % BUILDING
j
PLAN CHECK NO: USIEO 011 PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL
DOMAIN (CURB$, SIDEWALKS, DRIVEWAYS , MAAQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
�WSURCHARGF
P MIT APPLICATION: 180 DAYS
15 ER
PERMIT LIMIT: I YEAR, PROVIDED WORK IS STARTED WITHIN IBODAYS ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
BjqG. INSPECTION FEE
;Al'PlI.C'AN��,,.0%SlHALlTo0l Hl�� OR .�� SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
N NT 'E Ia.�S IN. MNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EC, A
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND mseEetaolm
ALL CLAIMS FOR DAMAGESOF WHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY
FRONITHEISSUA E OF THIS PEAMIT ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
DEEMEDT oMoDIFYWAIVE R REDUCE ANY RECUMEMENTOF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE AN' ORDINANCE PROVISION.* TOTAL AMOUNT DUE
2
ltistk
L
RECEIPT
0
1 HEREBY ACKNOWLEDGE THAT I H E READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT AM THE OWNER. OR THE DULY A THORIZED AGEN
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
CALL
a all -it an) ligIld by In,
B'jjT i,app, en,,etep.
d,,g 011,al 0, hina,,, Dapel, and Fees am d� and
TION: -0 IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF TH STAT F WASHINGTON RELATING TO
FOR INSPECTION
*,pt 1, anknowlindged in spano providodi
WORKMEN'S COMPENSATION INSURANCE AoRCW 18.27.
(425)
OFFI IALS SIGNATURE #12_jj�
ATE SIGNED
-3 Al
771-0220
EXT 333
ISLE ED Y 0 TE
24-
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL�FILE - YELLOW -INSPECTOR
TE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER - GOLD-ASSESSO13
z
0
m
'o
00
a
M
M
10
0 _n
n
m M
a
0
0
a Or)
c CA
0
z
m
FINn PROJECT APPROVAL
T 0:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE—
A�—ENGINEERING DIVISION DATE-4��,�
PLANNING DIVISION DATE —
SITE ADDRESS -7 30L
PERMT # INSPECTED --
DESCRIPTION OF WORK TO BE INSPEC
was conducted to determine compliance with approved plans. Final approval denotes that
Afield inspection
there are no objections from the above signed Department to the granting Of:
Final approval of the described work
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
—RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvi.doc.l:temp:bldg:forms6/98
z
0
C M
MO
0
80
C
M
M z
'0-q
C —Z
o -n
n
M M
0
0
0 M
C co
K U)
M 0
z
74
z
--I
U)
z
0
4
0
M
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ................
FOUNDATION:
Footing .............
Wall ...........
Pier/Potch .................
Z,
0
-4
—kl
Retamirig Wall ..........
Slab Insulation ..........
—1 -n
PLUMBING:
Underground .............
M,
IR
Rough4n ............
-4-
0
1
Commercial Final
HEATING:
ITI
Gas Test ....................
>
Gas Piping ................. .
Equipment ..................
Commercial Final
rn M
E)CrERIOR SHEATHING
NAILING ...................
FRAMING ................
rn 0i
FIRST FLOOR FRAMING
INSULATION : ..................
Floor Insulation
z
Wall Insulation ...........
Ceiling Insulation
z
SHEETROCK NAILING
-04
SPECIAL INSPECTION
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
v
po-Gl't Roubac PERMIT EXPIRES
PERMIT S003q4
ZONE
CITY OF EDMONDS
NUMBER
C
CONSTRUCTION PERMIT APPLICATION JOB SU TEtART#
ADDS
� IINESS
R NAMEINAME OF B
I, �JAME
-s" II Lo, tA I I tq Or7l LL( .
LOT NO
PLAT NAMEISUBDIVISION NO� LID NO,
.....
LID FEE S
MAILING ADDRESS
TFS—CPAR-1 0
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP R,
c
zip
EXISTING — PROPOSED 0
0
CITY ITELEPHINI
C,
REQUIRED DEDICATION PT — _
0
NAME
oc_ tJ4 I Ncelzc,
11
METER SIZE I LINE SIZE. 10, OF FIXTURES YEPRY SIGUIRID
S C3 NO 0 F
70—DRESS
�je
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY
191--%ticat
NAME
E INEERt 6 REVIEWE-1h
!�1,2 .00 6
AlDIIEl
so -to
FIRE REVIEWED BY DATE
ZIP
CITY TELEPHONE
I ul.Llor 'I Ul
S '612 )93 1
�! 5
VARIANCE OR CU SHORELINE OR ADON
z
STATE LICENSE NUMBER EXPIRATION -
'BON"
OSTED
ol�A II bz�� I uk;I
SIGN AREA HEIGHT
YY TAX ACCOUNT PARCEL NO.
15-/64-000_
SERA REVIEW
COMPLETE �EWP ALLOWED PROPOSED ALLOWED PROPOSED
EXP
,JPROPES
LOT COVE AGE REQUIRED SETBACKS IFT) PROPOSED SETBACK$ IFT.
UPSIDE REAR
ca
SFEI 0 PLUMBING MECH
�`WDIW DENTIAL
ALLOWED PH FRONT SIDE REAR FRONT
ROPOSED
0 rn
COMPLIA CE OR
ADDITION )a�bOMMERCML 0 CHANGE OF USE
c
M 0
0
C3 'REMODEL C3 APARTMENT SIGN
PARKING LOT ARE IEWEO
REOG I'Rov"'D
-40
0 c:
I R PAIR GRADING I B FENCE
E Cy S X
m
DEMOLISH TANK C] OTHER�
10
c —
RETAINING WALL C] RENEWAL I
o _j
CA PORT So,
"SHY . . .....
o
lIT
r (TYPE OF USE, SUWN!r�,Ty,)EXPLAIN:
p OF C C occr)
E ED BY' I -Ty GROU
0 *n
-n
SIT,_
NUMBER NUMBEROF SEAS 1�
DW LUNG
E ICIAL INSPECTOR AIIE� OCCUPANT,
LOAD
OF U.S.
STO RIES
R DIRE C] YES
M M
DESCRIBE WORK TO BE DONE 15.17
G,A t. j_tj REMARKS
4S PER UBC 108/FINAL INSPECTION REO` �p
o vi
0
xi,+Mm
lew4J n�,^Wr /Sodo'
0
c: 0)
c - �
_�Iew �� I � ;
Af- yq
:�j �14 I
M 0
-Z -
-t-0 c_ycceo
/VL4?2�
/n t4s)'Ae III
VALUATION FEE
z
PLAN CHECK FEE
HEAT SOURCE LOT SLOPE I
z
DATE
PLAN CHECK NO: r
PLUMBING
0
�VE5111)
MECHANICAL
m
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
L BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
WILL REQUIRE
GRADINGIFILL
2 DOMAIN (CURBS, SIDEWALK% DRIVEWAYS, MARQUEES, ETC.)
SEPARATE PERMISSION.
OWSURCHARGE 5—
PER111TAPPUCATI N: TOO DAYS
PERMIT LIMIT'. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEEBACK OF PINK PERMIT FOR MORE INFORMATION
ENG. INSPECTION FEE
-APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSI SANDSUC ES RE
IN NTERES,A REES DEMNIFY, DEFEND AND HOLD HAS LESS I.E ITY I
A c 0,cc (I sk
N. I S OFFICIALS, EMPLOYEES, AND A NTS F M ANY AND
X EDM N . ASHINGT N. I ARE TLY P INSINECILY
ES
I_NsREeTmwTEEC.
RECEIPT
AULD I SFORDAMA .. - - - -
THE ISSUANCE F THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
FRO
DEE EDT DIFY. AWE R REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NORLI ITINANY YTHE C TY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
RECEIPT
DUE
TOTAL AMOUNT
I HEREBY ACKNOWLEDGE THAT I HAVT READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IF ..ER, OR THE DULY AUTHORIZED AGENT OF
APPLICATIONAPPROVAL
Thl
=.�,r.
THEOW I AD. TO 0. W,THCIT AND STATE LAWS REGULATING CONSTRUC
NS�o'GFRCTE,. AND CHATPLY.
CALL N=,. d
0
TION.OANITIloN DING THE WORK AUTHORIZEY THEREBY, NO PERSON WILLSE EMPLOYED
CODE OF TH STATE OF WASHINGTON RELATING TO
FOR INSPECTION
IN VI LA No . TH LABOR
WORKMEN'S COMPENSATION INSURANCE A DIN 18.27.
OF IQJ LS SIGNATURE D71
(425) '112 m
DATE SIGNED
! :." _8
771-0220 RELEA D Y DATE
EXT 333
ATTENTION
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
ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 10 9
FAX PINK - OWNER - GOLD -