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20000391.pdf__'rDATE RECEIVED '-'% [PERMIT E�XPIRES Z CITY OF EDMONDS E PERM NE UMB IT IN ER -7;0 6-eo Lcq)_,t� CONSTRUCTION PERMIT APPLICATION JOB ADDRESS F1 owt,� OF FLAT NAMEISUBDIVISION NO� I LOT NO, I'll NO LID FEE S 0 MAJLI�G ADORE s PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTIN PROPOSED G REOUIREDDEDICADON_ FT TESCP APP—d 0 _._IRl 0 0 0 CITY ZIP "I-to2.o EA.,njo, Ohao TELEPHONE -1) NAME NO. OF FIXTURES PRV REQUIRED YES 0 N. 0 ADDRESS R MARKS OWNER/CONTRACT CITY NAME __7E_VlEWED/DATE ENGINEERING m ADOP.SS S. 6&y- Mo FIRE REVIEWED By DATE CITY Zip TELEPHONE 0 VARIANCE OR GO SHO;;LINEA CTION CO ON. BOND POSTED STATE LICENSE NUMBER PAW SEPA REVIEW EXP __:ADS# N ALL ED I PROPOSED HEIGHT ALLOWED I PROPOSED PERRY TAX ACCOUNT P RCEL NO. 3pn 00 — 0 NEW RESIDENTIAL 0 PLUMBING / MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT) FRONT SIDE REAR PROPOSED SETBACKS NET) FRONT URSIDE REAR C:] ADDITION COMMERCIAL o COMPLIANCE OR CHANGE OF USE IEWED By DATE REMODEL APARTMENT C] SIGN REao I PROVIDED FENCE GRADING CYDS X 0 REPAIR 0 X FT) MARKS C] DEMOLISH TANK cl ..H.. r GARAGE ETAlNINGVVALL D C] RENEWAL CARPORT 0 E_ 'R ITYPE OF USE, BUSINESS On ACTIVITY) 1E.1— NUMBER NUMBEROF CRITICAL NO AREAS OF DWSLLI U N U STORIES pA T p 89 SF PANT DESCRIBE WORK TO BE DONE REMA KS PROGRESS —p—Tintis PER UBC 108/FINAL INSPECTION RED: VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING % LOT SLOPE % BUILDING PLAN CHECK NO: �VESTED DATE 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, MARQUEES. ETC�) WILL REQUIRE SEPARATE PERMISSION. STATE SURCHARGE P MIT APPLICATION: 180 DAYS E IS PERMIT LIMIT. I YEAR - PROVIDED WORK STARTED WITHIN 100 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 0 ID ON BEHALF OF HIS OR HER SPOUSE, HEIRS. AS SIGNS AND SUCCESORS M ;APPLICANT, LESS T E ITY F I N INTERlSTIAGRl.lTlT,0 :TDIMNIFY, DS L HA NY AND ENTSIR LANDSCA G M.ND,,W IKN FF,CIALS,E PL YEES�AN A 2 ED I E CTLY INDIRECTLY ALLCLAIMS FOR DAMAGES OF WHATEV R A RE,ARISN INSPECTION FEE ISIR x FROM THE ISSUANCE OF THIS PERMIT. ISS A E F TH PER IT SHALL N T BE FLA I CHECK DEPOSIT 0 OR REDUCE ANY IRE ENT FANY ITY RDIN E , 05EMEO TO MODIFY, WAIVE B F R EANY ]NAN E PH VISt N.' R CE!E L-4 0 NOR LIMIT IN ANY WAYTHE CITY'$ ABILITY T E TOTA 'L AMOUNT DUE HAVE HEAD THIS AppCATION� THAI THE INF RMATION APP ICATION APPROVAL IHERE GIVEN I l=TBA--l-AT THE Ow ED AGENT OF By L DGE THAT: AM NED . OR THE DULY AUTHO , h � ll� I- 1� 1 �Pt li Ll" lg� 11 THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC - CALL h"'_ tV ald F a,O d� .�d 0 0 TION; IND IN DOING THE WORK AUTHORIZED THEREBY. No PERSON WILL BE EMPLOYED WASHINGTON RELATING TO __,.d�'d �� _PP d, FOR INSPECTION IN VIOLATION OF THE LABOR CODE OF THE STATE OF WORKMENS COMP5NSATK)l INSURANCE AND RCVV 18.21. FFICIALS SIGNATO DATE IGNATURE(OWNER RA T) D E SIGNED (425) E I A, � 21� 14= __j 771-0220 R -LEASED By -@FE—NTION EXT 333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 FINAL INS ECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- P ORIGINAL FILE YELLOW - INSPECTOR - ASSESSOR A CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD 5196 Z J 0 T 3: c M m 00 oc r. m m JD c -4 0 m M 0 0 FTI C (j) 0 z --I z 0 d 0 m ! M FINAL PROJECT APPROYAL FORM TO:—, -DATE: MEMO TO' PERMIT COORDINATOR, BUILDING DIVISION FROM: DEPARTMENT DATE-�:� z —ENG G DIVISION DATE- -- -- ------- --------- PLANNING DIVISION DATE — vi a rn C a rn PROJECT 0 -40 0 C SITE ADDRESS -73 o g9a*<lLioxg jQA -4 K = M rn 10 z PERMIT # SO 0 - ADB#-------DATF INSPECTED -IL— I —V-2`5"' 0 �; -4 _31 PECTED_fU/�_ 2 DESCRIPTION OF WORK TO BE INS .. L,_L� 0 -n n A field inspection was conducted to determine compliance with approved plans. Final approval denotes that M M 065 there are no objections from the above signed Department to the granting of 0 � 0 M approval of the described work a 6) 9 CD M 0 Z ___Z_Final Bonds associated with the project may be released M _Performance z GRANT FINAL PROJECT APPROVAL 0) z FINAL PROJECT APPROVAL WITH CONDITIONS NOTED _GRANT rn ___YAILED FINAL INSPECTION OUTSTANDING ISSUES I 2. 3. -RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL ocaprvi.doc.l:temp.bldg:forms6/98 RECORD OF INSPECTIONS CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION Ell mm o� 60Y ROPERTY TAX A ?;rn 6 0 NEW [3 ADDITION 0 REMODEL 0 REPAIR n DEMOLISH GARAGE CARPORT PERMIT EXPIRES J-L-t-1 -(&2j us PERMIT ZONE MIJIMBIER JOB ADDRESS PLAT NAMEISUBDIVISION NO. LOT NO. LID NO, Aim V_ P LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP A 0 00 IP :�' Z -Fiji lq-02,0 TELEPHONE EXISTING — PROPOSED _7� 1 9�1� REQUIRED DEDICATION— FT wel-.1—1 0 METER SIZE LINE 1111 NO, 01 FIXTURES FIOUIREO YEPRV SO NO 0 REMARKS I, FOR EROSION CONTROUDRAINAGE ZIP T ELEPHONE A, T,-< ENGINEERING Ito %j REVIEWEDIDATE o DATE FIRE REVIEWED BY ZIP TELEPHONE r z lw4 1016- �vq* VARIANCE OR CU SHORELINE OR ADSM IN'PEC RON RE B PE.ND OSTED C) EXPI.Al OYES ONO 0 P N A BE. REVIEW SIGN AREA I COMPLETE EXEMPT ALLOWED PROPOSED ALLOW EDHEIGHTHOPOSED PAR . 00 EXP LOT COVERAG E REQUIRED SETBACKS (FT.) O_E.NETEACK� 111. M 0 RESIDENTIAL PLUMBING I MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT m 0 0 COMMERCIAL COMPLIANCE OR CHANGE OF USE c PARKING LOT AREA rm APARTMENT 0 SIGN REO'D I PROVIDED 0 FENCE X 0 GRADING CYDS I X ITI EMAR1. M z jo _ c_ U TANK 0 OTHER g 7 C] RETAINING WALL RENEWAL ROCKERY 0 -n OR ACTIVITY) EXPLAIN: CHECKEDBY jjgA�aONSTRZN U NT U N MBEROF CRITICAL CIALINSPECTOR AREA HT MITI _ I DWELLING AREAS S LOAD �TF 1, j� UNITS NUMSE Pt REQUIRED C3 YES go STORIES DESCRIBE WORK TO BE DONE AR 0 Fn "M Ks PH GRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D.� C 0) rn 0 cr,— —GAO u z VALUATION FEE PLAN CHECK FEE z HEAT S LOT SLOPE % BUILDING PLAN CHECK NIZU PLUMBING m MECHANICAL T.BBPEFMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO E DONE . PFBVA E PROPERTY ONM ANY CONSTRUCTION ON THE PUBUC GRADINGIFILL 2 (CURBS� SIDEWALKS, DRI DOMAIN VEWAYS. MARQUEE% ETC.) WILL REQUIRE SEPARATE PERMISSION. STATE SURCHARGE 2 P LIGATION 180 DAYS PERMIT A P PERMIT LIMIT.'I YEAR ' PROVIDED WORK IS STARTED WITHIN 180DAYS ENG, REVIEW FEES SEE BACK OF PINK PERMIT FORMOREINFOFIM ION �APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. �.INS AND SUCCESORS IN INTEREST AGREES TO:N EMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF ANY AND LANDSCAPING 2 EDMONDS. YVASHINGTON� TSOFFICIALS. EMPUOYEES� AND AD ENTS FROM ALLCLAIMSFORDA AGESOFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY M INSPECTION FEE RECEIPT FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL HOT BE PLAN CHECK DEPOSIT DEEMED TOMODIFYWAIVE OR FIDUCE ANY ITIQUIREMINTOF A�YCITY ORDINANCE TOMOD' 1111"AN11PIOVISION,' ANY 0 C L4 N OR LIMIT 1. ANY WAY THE CITY'S ABILITY TO ENFORCE TOTAL AMOUNT DUE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL I HEREBY CHV�N IS �OFFIE%IAND,�HATPILA' THE OWNER. OR THE DULY AUTHORIZED AGENT OF 'e'"" V�Ie �,q by be THE OW N" 'A'R To M YWTH CITY AND STATE LAWS REGULATING CONSTRUC- CALL S,e,, I, , 1='PTY led Fell 11, p1le—d OY TION: AND,JN 0 ING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE L"FL E WASHINGTON RE AT NG TOD FOR INSPECTION ,.,,pt I, ackemledg-d 'e H, —d- IN VIOLAT ON OF THE LABOR CODE OF THE STATE OF WORKMEWS COMPENSATION INSURANCE AND PCW 18.27 F51CIALS SIGNATURE-.,, DATE IGNATURE JOWN AS NTI 0 E SIGNED (425) k <1 JL�ZgLOO� 771-0220' E LIASED.Y EXT 333 E TION IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 P FINAL INSPECTION HAS BEEN MADE AND A PROVAL OR A CERTIFI- ORIGINAL,FILE YELLOW -INSPECTOR -ASSESSOR A HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER GOLD CATE OF OCCUPANCY