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20000394.pdf--i DATE 2... CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS CITY 'I, ITELEP"011 NAME ADDRESS I IF F CITY TE'S .. NE NAME 51) co I/ lktJ A -A , /Z C ADDRESS Q PERMIT EXPIRES PERMIT 2063N NUMBER los ADDRESS PLAT NAMEISUBDIVISION NO. LOT NO L.0 NO. G 0 U. FEE Ii PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP A, 1— 0 W P., qd EXISTING — PROPOSED REOUJRED DEDICATION FT METER SIZE LINE SIZE N, OF, F;r U, HE. RE-U RED I EPFW SO NO OWNERICONTRACTOR RES-14SI.I.E 1.11 .01�.N C.NTROLJDFAINA CIS FIRE REVIEWED BY DATE CITY ZIP TELEPHONE 73? SHOR c, ga 2,1. VARIANCE OR CU LINE OR ADBII INSPEECTION REO'D OSTED STATE LICENSE NUMBER ii4 OYES ONO PON 156u-rij cp 1617�Sq—� & 131 Jim I U SERA REVIEW COMPLETE EXEMPT M PLETE C -0 SERA :R� P EXP X SIG AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED M��OUNTPA3LQ , 4 -Z Oq #PLUMBING RESIDENTIAL (er I MECH LOT COVERAGE LOT ALLOWED PROPOSED RSOUIREDSETBACKEIff.) FROI PROPOSED SETBACKS (FT.) 'A SIDE REAR ADDITION ,�MMERCIAL I c3 C MPLIANCE OR CHANGE OF USE I PARKING LOT AREA I PLANNING REVI—tu Uy DATE C3 REMODEL 0 APARTMENT m SIGN FEUD I PROVIDED [3 REPAIR 0 GRADING CYOG C3 PENCE X FT) -ITEM-K. n DEMOLISH C3 TANK 0 OTHER 0 GARAGE FIMNINyl WALL 0 F.NB..AL G Rl..T R (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CHET -T coo OCCU ;? F. NUMBER OF "T'IAL SPEC AREA OCCUPANIT OF G STORIES S AREA ER NUMBER MEG REQU YES LOAD DESCRIBE WORK TO BE DONE REMARKS 'T PER UBC 108/FINAL INSPECTION REO' PLAN CHECK FEE HEAT SOURCE BUILDING PLAN CHECK NO: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFKL DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS' MAROUEES. ETO) WILL REOUIRE SEPARATE PERMISSiOM PE MIT APPLICATION; IBB DAYS PERMIT LIMIM I YEAR - PROVIDED WORK I$ STARTED WITHIN 180 DAYS ENG, REVIEW FEES ENG, INSPECTION FEE SEE SACK 0 PINK PERMIT FOR MORE INFORMATION , �AP PLICANT, ON BEHALF o P HIS OR HER SPOUSE. H@Rs�.SSIGNS AND SUCCESORS CITY OF IN I NTEREST. AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE 2 EDMONOS� WASHINGTON, ITS OFFICIAL& EMPLOYEES, AND AGENTS FROM ANY AND LANDSCAPING INSPECTION FEE LOTAIMSFOR A AGESOFWHATEVER NATURE,A RECTLY OR INDIRECTLY AL D M R'S'THGjGPERMIT SHALL NOT BE DEPOSIT m FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF OF ANY CIT Y ORDINANCE REDUCE ANY REQUIREMENT PLAN CHECK , DEEMED TO MODIFY. WAIVE OR 0 VISION,* INANY WAY THE CITY'$ ABIUT TO ENFORCE ANY ORDINANCE ROVISION, 0 NORLIMIT TOTAL AMOUNT DUE I' I HEREBY ACKNOWLEDGE THAT I HAVE READ TH S APPLICATION, THAT THE INFORMATION GIVEN IS CORRECT AND THAT I AM THE o"NE�. OR THE DULY AUTHORIZED AGENT 01 REGULATING GONSTRUC CAL L THEO NER I AGREE TO COMPLY WIT. CITY AND STATE LAWS w E EMPLOYED WO AUTHORIZED THEREBY, NO PERSON WILL B T IoN: AND IN DOING THE L LAG CODE OF THE STATE OF WASHINGTON RE ATING To FOR INSPECTII IN lIoLATInlPl,"l woR PENSATIO INSURANCE AND RCW 18,21, E NS XL _ 2 DATE E (425) ru L�41 771-0220 EXT333 AiiWTION' IS LWLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 IT INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI- A FINAL HAS BEEN GRANTED. UBC SECTION 109 FAX CATE OF OCCUPANCY VALUATION I FEE g PT APPLICATION APPROVAL by Ih. d d 0 TN� AlIl 1— 11 1-11 11' -T-" "y" q 0�,, ., �p T ATURE, I —AT A. FAIED 8 ORIGINAL � FILE . yeLLOW.IN�PECT.R PINK . OWNER - GOLD - ASSESSOR z m c m m 00 80 c A g) -4 i�, c 0 -n n rn M 0 00"', c cl) .0 z z 0 i rn " m RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall .......................... p Pier/Porch _ ............... Retainlrig Wall .......... -4 ITI Stab Insulation .......... PLUMBING: _0 Underground ............. M Rough -in ................... -------- W_ ITI 0! 0 Commercial Final C HEATING: M M 10 Gas Test ..................... Gas Piping o, ................. Eant ............. quipm Commercial Final MA EXTERIOR SHEATHING NAILING .......................... FRAMING ................ C M 0: FIRST FLOOR FRAMING ff INSULATION ................... Floor Insulation Z, Wall Insulation ........... Ceiling Insulation . ....... SHEETRObK NAILING SPECIAL INSPECTION ITI MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. 77 '10A 'DATE RECSIVE ,( ),.� "PERMIT EXP RES w ,, k USE CITY OF EDMONDS PERMIT ONE 394 NUMBER CONSTRUCTION PERMIT APPLICATION JOB ADDRESS MITI OWNER NAIIIINAMI OF BU INESS pvt1a cle o t 5 o PLAT NAMEISUBDIVISION NO, I LOT NO, LID NO. 11. FEE S 1. ;, " I 0 .1. a zl:v 0 MAILING ADDRE S :Sr PUBLIC RIGHT OF WAY PER OFFIC;AL STREET MAP EXISTING - PROPOSE IT REQUIRED DEDICATION FT CITY - ZIP JTELEPHONE 4_10 All Jl; 5 '37 0 1-6 METER SIZE I LINE SIZE NO,OFIF PRY SOURED YES 0 NO 0 NAME ADDRESS REMARKS OWNERICONTRACTOR R RAINAGe CITY ZIP NAME 56WI4 cou f tlltA Ic //I- ENGINEERING JEWED . I ATE z 0 :_j i I 0 m 3: a m c 0 : % m 0 0 0 C M A G RS� DDRSSS FIRE REVIEWED By DATE CITY ZIP G "0; SHORELINE OR AOB4 J'j7SPECTION RED G rly Es ONO I BOND IPOSTED ST E L�MCENSE NUMBER AT l5at"I'l cp I&I SEPA REVIEW G ETE EXEMPT SIGN AREA ALLOWED PROPOSE HEIGHT ALLOWED PROPOSED - P FT�T_Y;y, COUNTPA�ILCf 14 5 NEW Y�rFLUMBING I MISCH COMPLIANCE OR C] ADDITION CHANGE OF USE C3 REMODEL SIGN c GRADING C S C3 FENCE REPAIR Y X FT) COVERAGE OT SED AL4WED PROPO ETS I REQUiREDS ACKS(Fr. FRONT SIDE REAR PROPOSED SETBACKS (M FRONT UP SIDE REAR PARKING LOTAR�A REOUD I PRO IDED jPLlNNING81VEWlD,BY DATE B.AF- DEMOLISH TANK o OTHER R Ip WALL - o GARAGE ETA RENEWAL _2N NG CARPORT 0 @ BAY 0 n m m 0 0 o rm C= CD or _�Type OF -USE, BUSINESS OR ACtlVftY) E�RIUUN: cc flt. o CNECKCD BY YPE D 0 U NT GROU NUMBER HUMBER 0, 'WELLING OF UHIT, .0 'o STORIES REAS NUMBO LINSPECTOR 0 YES AREA OCCUPA LOAD DESCRIBE WORK TO BE DONE p 0 REMARKS PROGRESS INSPECTIONS PER UBC 108/FINA NSPECTION REO'D CIO 0 z V FEE z PLAN CHECK FES E-U-S BUILDING m PLAN CHECK NO: PLUMBING MECHAMICA LYTHEWORKNOTED THIS PERMIT HIS PERMIT COVERS WORK TO AUTHORIZES ON T Be DONE ON PRIVATE PROPERTY ONLY, ANY C�11; RUCTION ON THE PUBLIC 9 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS , MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSIOM GRADINGiFiLL URdHARG5 MIT 0 Aft- 5 PE WITHIN 180 DAYS . PERMIT LIMIT. 1 YEAR - - r AMATION G.REVIEWFEES PROVI dg- IN SEE BACK 0 PINK p 0 w 'A PLICANT, ON BEHALF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS NG- 71NSplNTIOl FBI F 7_ ___ p 11,05NINIFY. DEFEND AND HOLD HARMLESS THE Ul I Y UF AN. Ap IN INTEREST, AGRSES TO E MONDS,WASHtNGTON. ITS OFFICIALS. EMPLOYEES A 1) AGENTS 1H.. ANY AND INSPECTION FEE WHATEVERNATURSARiN.G�R TLYORINDIPECTLY A OF H RECEIPT A 1,121 DA IS PERMIT SHALL NOT BE ��ln _., PERMIT, ISSUANCE OF TH ANY CITY ORDINANCE PLAN CHECK DEPOSIT DINANCE PROVISION.' TOTAL AMOUNT DUE RECEI - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL RFH DULY A TH.RIZEDA.ENT.F V&Cl np I atiOn I' SIX, jj,,tIsIgn.dbyIh0 U LL dlhi� d n, H.1 "' D, �nnd'F.'I-PNn,nnd GIVEN IS CORRECT� A DTH �'LyAMWTTH�"OITWYNA'�R6�OTATEELA.S GULATING CONSTRUC- ouilT THE OWNER, I AGREE TO CO� no h 0 PE RSON WILL BE EMPLOYED 01p Pl'o'dg innP-P-lid-V TION AN IN DOING THE W. ALIITI..�,'�T�- T WASHINGTON RELATING TO q GOES HE STATE I FOR INSPECTION IN VI LAT F THE AT COPP'N' LAI WOR E ATIO INSURANCE AND HOW 18.27, OF ON UPS HER 08 T) DATE ED SIGNATU S, (425) 7 -0220 ASED BY DATE 71 RE EXT 333 ITIS LAWFULTOU E OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 ORIGINAL - FILE YEL INSPECTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- LOW CATE OF OCCUPANCY HAS BEEN GRANTED. LIDO SECTION 109 FAX PINK - OWNER COLD ASSESSOR