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20000364.pdf*2;4 DATE RECEIVED , L... CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION PERMIT EXPIRES us PERMIT ;Zo(Z521111 ZONE NUMBER _j6q JOB S ITEIAPT# ADDRES9A 141 Q ) e_ / I — P�T NAMCISUBDIVISION NO, LdT NO. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP LID NO. LID FEE $ ZIP TELEPHONE PROPOSS. EXISTING PROPOSED — REQUIRED DSOICATION_ FT TEASIZE 1INESIll E TS. BZ. IN BZS NO OF FIXTURES NO- OF FIXTURES P FV SQUIRED IES 0 No 0 ADDRESS CITY ZIP TELEPHONE OWNERICONTRACTOR RESPONSIBLE FOR ERQS FIRE MARSHAI ........ .... MUSI BE PRESENT FOR NAME TANK FiLL, REMOVAL, OR CAP ENGINEER! HCVIEWEDIDATE ADDRESS FIRE REVIEWED BY DATE ZIP I TELEPHONE 0 VARIANCE OR CU SHORELINE OR ADS. INSPECTIO N STATE LICENSE NUM REGO PSCONTSD OYES ONO ',IGNAREA — HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED _jpROpl 0.§jWT PARCEL NO 170c) 00fo tl)� EXP NEW PLUMBING MECH LOT COVERAGE REQUIRED SMACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT UPSIDE REAR COMPLIANCE OR ADDITION CHANGE OF USE PARKING 11A PLANNING REVIEWED By DATE 0 REMODEL 0 SIGN PEO'D I PROVIDED REPAIR E] GRACING Y.S C3 FE'CS X _ FT� ARKS DEMOLISH ,�Z TANK GARAGE C] RETAMINGWALL RENEWAL CARPORT __FRY — 0 0, 1, DWELL NO STORIES UNtTS_ DESCRIBE WORK TO BE DONE � I ;,E=OK ED 'Y TYD ED 'Y E ED, CIAL IN�a.YT,.l .U,.S. S REQUIRED 0 YES PER UBC LOAD VALUATION FEE HEAT SOURCE GLAZING % LOT SLOPE % c� PLAN CHECK NO: THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS P BE DONE ON PRIVATE PROPERTY ONLY. ANY CONST RUCTMON THE PUBLIC GRAOINGIFILL DOMAIN ICURBS, SIDEWALKS, DRIVEWAYS, MA QUEES, ETC-. ,LLNE.Ul.E :i SEPARATE PERMISSION. L STATE SURCHARGE PERMIT APPLICATION: 180 DAYS PERMIT LIMIT, 1 YEAR. PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION P HER SPOUSE, HEIRS, ASHSIGN PLICANT. ON BEHALF OF HIS OR HER SPO ;A AGREES TO INDCMNIF Y IAR E SS T' E ITY F .. AN,`E�SOL�`D LAN SC NO GINTEREST. AGENT 2 E MONOS� WASHINGTON� ITS OFFIC , E.,L. A SIR INC NY AN INSPECTION FEE ALLCILAIMS FOR DAMAGES OFWHATE,_ . , - . E OF THIS PERMIT SH Lt- NOT BE PLAN CHECK DEPOSIT RECEIPT I S S UANO I FROM THE ISSUANCE 01 THIS I WAIVE OR = ANY REQUIREMENT OF AN' C TY ORDINANCE DEEMED TO MODIFY, ILITY TO ENFORCE ANY ORDINANCE PRO—IOM' 0 NOR LIMIT IN ANY WAY THE CiTYtS ABILI T TOTAL AMOUNT DUE RECEI[l I HERE Y ACKNOWLEDGE THAT I HAVE READ THIS APITLI.C�ATI�OLY THAT THE INFORMATION 81S APPLICATION APPROVAL GIVEN CORRECT: AND THAT I AM THECOWNENR6 OR U AUTHORIZED AGENT OF Th—IP11-1- '� - � P`� THE OWNI I AGREE TOCOMPLIWITH tYA STATE LAWS REGULATING CONSTRUC- EMPLOYED RINDOIN CALL Off'P., - P�l� -� D puly: ,F F THEWORKAUTH ED THEREBY. NO PERSON WILL BE TION: ANDION G OR" TON RE ATING TO WASHINGTON FOR INSPECTION focopi ss ackn.d,, i� P.. IN VIOLAT 01 THE LABOR CODE OF THE STATE OF A�4 RCW I E DATE WORKMEN'S COMPENSATION NIURANOI I _ T DATE SIGN 0 (425) OFFICIALS 79",b_ !: �l ". 771-0220 IZILEASED By _MP,OR EXT 333 ATtENTRIN IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR A FINAL HAS BEEN GRANTED, USC SECTION 109 FAX PINK OWNER GOLD -ASSESSOR CATE OF OCCUPANCY z =I 9n m c m 0 80 a m m 10 _z 0, n� �c , " I rn T13 (a 0 o z x z m , M z 0 1 0 m 0 C: m M 0 -q 0 0 -49 m m m z 0 1 c 0 n -4 M M - (j) 0 r- 0 M C cf) 9: (n M C-) z -4 z 0 A 0 m RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Fooling............... Wall .......................... iA., z Pier/Porch ........... p� Retainlrig Wall M� Slab insulation .......... PLUMBING: —v x M, Underground ............. C: M 01 fgL�' Rough -in ................... commercial Final IT1 Z HEATING: C GasTest ............... Gas Piping ................. ca 0.n Equipment ................. Commercial Final rn i, EXTERIOR SHEATHING 0 0 NAILING .......................... C: 21), FRAMING ........................ I I In FIRST FLOOR FRAMING INSULATION ................... Floor Insulation Wall Insulation ........... Ceiling Insulation z IP SHEETROCK NAILING M SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. DATE RECEIVED use ZONE CITY OF EDMONDS ADDS CONSTRUCTION PERMIT APPLICATION I"' -E� -), T`77177r PERIAIT b(ARES (X-) PERMIT NUMBER n 7—NO III) NO. PUBUC RIGHT OF WAY PER OFFICIAL STREET MAP I sno., ... P-1 P.0 I EXISTING — PROPOSED — In A'0.a I SW- Paq.Usd I CITY ZIP TELEPHONE ACQUIRED DEDICATION— FT — IInd Hna -all., KONG ME! E A SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED NAME YES 0 NA E ADDRESS 0 FIRE REVIEWED BY DATE ZIP TSLEPHONE 0 VARIANCE CTR CU SHORELINE OR ADSN INjPECTION REDO BON POSTED DATE CH STATE LICE14SE NUMBER OYES rINO SERA RE IE SIGN AREA HEIGHT CC PLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED PROPERTY COUNTPARCE NO.. EXP 0 NEW XSESH)ENTIAL M PLUMBING t NECK REQUIRED SETBACKS IFT) 0 OlPR E AR LOT C E AGE SID RE ALLOWE ROPOSED FRONT PROPOSED SETBACKS FRONT UR SIDE AE'A�R 0 A0111TION C3 COMMERCIAL o COMPLIANCE 08 CHANGE OF USE PA KING LOT AREA PLANNING REVIEWED BYi DATE C] REMODEL C] APARTMENT SIGN RE 'D PRO IOED FENCE X 0 REPAIR 0 GRADING CYOS 0 X FIH RE ARKS DEMOLISH ,�K TANK C3 CAR . 0 ADD �&G.AFIAGl RETAKINIIIYG WALL RENEWAL .±T F USE, BUSINESS CHECKED By TY--�- Tr, OCC.V NUMBER NLIMILILE"N1.0 OR I L AT SPECIAL INSPECTOR AREA ;u NT OF Ov C ITS sa. F 0 STORIE S UN , DESCRIBE WORK TO BE DONE =AAKS... —PPrTinmq PER USC 1081FINAL INSPECTION REG VALUATION FEE PLAN CHECK FEE -1, HEAT SOURCE GLAZING X, LOT SLOPE BUILDING PLAN CHECK NO: ... PLUM51NG MECHANICAL UTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO PUBLIC L BE 0 NE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE REQUIRE GRADRIGIFiLL a D MAIN JCURBS, SIDEWALKS DR VEWAY MAR UEES, ETC.) WILL .3 E 0ARA' T PERlSSION. L STAT E SURCHARGE 2 PERMIT APPLICATION: ISO DAYS PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES PERMIT LIMIT: I YEAR ' SEE BACK OF PINK PERMIT FOR MORE INFORMATION 0c) ;APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESOAS E 0 LESS THE CITY OF NED FEMNpDLAy LANDSCA AD A INTIRCSTAAGAI.ITI.T.0 NGOEM I E0A`ND=TS FROM ANY AND EDMOND :T FNIFYLD � 0 E F C14 S, E INSPECTION FEE ,W ALLCIAIMS FOR DAMAGESOF WHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY PERMIT SHALL NOT BE DEPOSIT FROM THE ISSUANCE OF THIS PERMIT ISSUANCE 05 THIS To MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANYCITY ORDINANCE ' PLAN CHECK c' DEEMED NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION TOTAL AMOUNT DUE RECEIVs7 ANOT READ THIS APPLICATION! THAT THE IAF AMATION APPLICATION APPROVAL I HEREBY ACANOWL�AO�G.'T.HAATT: " CORRECT AM HE OWNER OR THE DULY AITIQRI�10 A ENT 01 Tall IPPIX-b-P is Pan - 'y ". GIVEN N FEEL, NG CONSTRUC- E 'HYA 6BATELA.B TT','.E,QA`,N,)A CALL Snal op,lyi,nd Foos an, nd, and dn,goffiow li D N C'A,,G,,RET.'E0.C.0�M<p=IlE THEREBY. No EPSON wu BE LE.PLOYED 0 RE ATING TO FOR INSPECTION n—P, 1. p,-d- STATE WASHINGTON IN V61-ATION OF THE LABOR CODE OF THE OF 18,27, — OFFICIALS SIGNATUR E WORKMEN'S COMPENSATION INSURANCE A� SCW AT (425) SIGN ORA T 771,-Q220 LEASED BY EXT 333 ENTI N TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTI L 771 -W21 INSPECTOR IT IS UNLAWFUL HAS BEEN MADE AND APPROVAL OR A CERT11 I- ORIGINAL � FILE YELLOW GOLD - ASSESSOR A FINAL INSPECTION HAS BEEN GRANTED� UBC SECTION 109 FAX PINK. OWNER CATE OF OCCUPANCY z 9 J, 0 0 c rn rn 0 MT 0 M m M 0 c- 0 0 c: m Z� X z z 0 m