20000409.pdfPERMIT EXPIRES
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CITY OF EDMONDS ZONE
CONSTRUCTION PERMIT APPLICATION JOB
PERMIT
NUMBER
SUITEAPT#
OW NE� NAMENAME OF BUSIN
NO
LOT NO,
I'D NO�
I D FEE S
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAI
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NAME
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ENGINEER114G Ht,,,,,DJDATE
IF ADDRESS
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SAAck
FIRE REVIEWED By DATE
CITY IZIP
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TEL PHONI,
VARIANCE OR CU
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SHORELINE OR A397
RC�O�TION
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STATE LICENSE NUMBER
SERA REVIEW
COMPLETE EXEMPT
EXP I
IGN AREA
S PROPOSED
ALLOWED
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HEIGHT
ALLOWED PROPOSED
PROPE 0 TPARCELNO.
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EW D RESIDENTIAL 'f�;:_-PLUMS;NGIMECH
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACK$ (FT.)
FRONT SID5 PEAR
PROPOSED S ETBACKS (FT.)
FRONT RSIDE nEAR
ADDITION COMMERCIAL 0 COMPLY, CEOA
CHANGE OF USE
PLANNING REVIEWED BY DATE
REMODEL APARTMENT SIGN
RED, I PROVIDED
FENCE
0 REPAIR ci GRADING CYOS C3 , _ X FT)
R-A.-
C] DEMOLISH 0 TANK o OTHER
0 RETAKIENIRNYG-LL 0 RENEWAL
ROC
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CHECKEDBY
Tj7pOFColSTRUCTION
_ I
NUMBER
IN
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0 STORIES
0
NUMBEI I
DWELLING
UNITS
CIlITIlAI IV,4
AREAS
NUMBER
IPEIIAIIN IICTOII
S
REQUIRED 0 YES
AREA OCCUPANT
LOAD
DESCRIBE WORK TO BE DONE
!�14
RIMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RED
IAII 4Z I
/0
VALUATION
FEE
PLAN CHECK FEE
3& 01
HEAT SOURCE GLAZING I LOT SLOPE %
BUILDING
30
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
GRADMOIFILL
DOMAIN (CURBS, ETC.) WILL REQUIRE
SIDEWALKS, DRIVEWAYS, MARQUEES,
I
SEPARATE PERMISSION.
SURCHARGE
.00
I IT APPLICATION: 100 DAYS
PE M
PERMIT LIMIT, I YEAR. PROVIDED WORK IS STARTED WIT PIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
OF
ENG� INSPECTION FEE
AND H LESS THE CITY
IN I.NoER11TA%GIE.ITS.T�0 NOE �IFY OLD =TSFROM ANYAND
T
�T -
LANDSCAPING
L.EllD
, NIPLO S
ED N F C'� �. E EE AND
�.. EH'N OR INDIRECTLY
INSPECTION FEE
ALL CLAI OF WHATEVER NATURE. ARISING DIRECTLY
M=AAlCA'oEFTHIS OF THIS PERMIT BHA
NtNAN BCEE
PLAN CHECK DEPOSIT
RECEIPT
FROM T PERMIT. ISSUANCE
HE 0 P ANY CITY OLLD
YR UPE.ENT
M EQ
DES GTOMOD,�y,,TA.,,OPREDUCE�
E CITY'SABI , E ROMANCE PROVISION.*
REG
L
NQR�E M,T,NANY.
THAT I HAVE REOADTHIRS. APPTLIHCEATIOLNY THAT IN' RMATION
APPLICATION APPROVAL
OTHE
I HERE ACKNOWLEDGE
GIVEN By F HE OR w AUTH RIZEDAGENTOF
IS Co RECT, AND THAT I AM TH
T"'. PPI-II.- ; .i, Mit �,v.d 4
W NI
E I WITH CITY RUC
FIl 0 Ly G LA S REGULATING Co T
MP
THE OWN AN �TATE ED
WILL BE EMPLOY
Quild"' 011" ... ... P.,d-,I
GAGRESTOC
TiON:ANDIN OING THE WORK AUTHORIZED T. ESY NO PERSON
IR TE 0 WASH, T.N PE, TN. T .
F N A
-1,1:10.1-lodged I, spaco P-lded.
TION
E S
IN VIOLATION OF THE LABOR CODE OF TH TA
WORKMENS COMPEN�ATIONJNSURANCE ANDRCW 18.27.
OFF CIALS SIGNATURE DATE
DATE SIGNED
(425)
2- -CO
SIGNATURE (OWNER AGE T)
-2:2--OJ
771-0220
RELErSED
EXT 333
A17ENTION
IT IS UNLAWFULTO 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
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER GOLD - ASSESSOR
5198
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� M
Maximum Occupant Load (Peft.I.B.C. 11002)
Room capaolty signs, fredj.W,' atill posted at alhimes.
Owner of Building: Sundollist fting,le- au' WA '98046
E
THE MQN R CONDQMIUMS-C COMPLYING WITH THE REQUIREMENTS OF THE
eliiijfil
E
0 4 1 1 AND DIVISION OF OCCUPANCY AND THE USE
HE UNIFORM BUILDING C OPTE
191LEDITION WT D CO%F
I
FOR WHICH THE PROPOSED OCCUPANCY IS D.
Issuedthis- 2001
CHjkF j6L&j�FibAl.
BY:
This wrtiffods shas be banned In a Public am 80 $bell nat W reaunad, mutgated or w—ed and alias be nainialned in legible condijan tal oines. Mychoqoof�paneymmmquimebuucongpwvgtand.aw
Csawn, of0ccupancy Issued by the Quy of Ednas,ids Building Offidal.
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing
wall
Pier/Porch .................
Z!
Retainirig Wall ...........
Stab Insulation
�4ls_ ei PLUMBING:
Underground ..........
Rough -in ...................
P�� J2
0 M
'M_ 00
V,.W- UVX-41
-10
Commercial Final
C
M
HEATING:
10-4
Gas Test ................
>
Gas Piping .................
Equipment .................
Commercial Final
M.
EXTERIOR SHEATHING
M
NAILING ..........................
FRAMING .................
M
r
FIRST FLOOR FRAMING_
INSULATION ...................
50,
Floor Insulation
Z,
Wall Insulation ...........
Ceiling Insulation
z
SHEETROCK NAILING
0�
_q
0
SPECIAL INSPECTION
A
MISCELLANEOUS ..........
FINAL APPROVAL FO R
OCCUPANCY ..............
� IN
"'iffE RECEIVED
IR
PERMITEX. E
PERMIT
CITY OF EDMONDS ZONE _NIM.ER
JOB SUITE.PTI
CONSTRUCTION PERMIT APPLICATION
OWN11 NAMEMAME OF IUIINV LID NO�
PLAT NAMEISUBDIVISION 140� LOT NO,
_Z�Ve
LID FEE S
_I
C1 AILI GAO SSM
PUBLIC RIGHT OF WAY PER O�NCLAL STREET MAP AW P. a
coca U.. A.aa 0
00
ITILEPHONE EXISTING — PROPOSED
zip � RECURS. E.F,ATK,K_ PT _— ii—ao.
NO.OFFIXTURES RED
METER SIZE I LINESLZE7__f
YE.X"UN'
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REMARKS
NER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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ZIP
TELEPHONE
NAME
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CITY zip TELEPHONt
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STATE LICENSE NUMBER
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VARIANCE OR CU
7LINE OR ADBR
INSPECTK)
OYES ONO
IPBO 0
OSTED
COMPLETE EXEMPT
SIGN AREA
ALLOWED I PROPOSED
HEIGHT
ALLOWED , PROPOSED
I ROPEAT TAX AD T RCEL NO*
Y
-oc]�WESLDENTIAL MBING MECH
VMI,11 PLU
MPLIANCE OR
C3 A1111ON � l C] COMMSFICIA(P d�CHANGE OF USE
�IL Sj
,1 APARTMENT 0 SIGN
C3 .
PENCE
REPAIR o GRADING CYDS
DEMOLISH,-',, 0 TA14K 0
E 0 1,11TAINII1yG WALL RENEWAL
0 CGAARPAOGFT
VERAGE
AILLOWEID PROPOSED
`v
71SOL RED SETBACKS (FT.)
FRONT SIDE REAR
PROPOSED E tAC �S (FT.)
F
_701z� U -(- \ -
PARKING LOT
FlEaD I PROVIDED
AREA
rNNINGREVICWED BY DA
AEMA.I.
.0
P (TY;PEqF USE. BUSINESS OR CTIVITY) EXPLAIN:
CHECKED By
"ON TR�Wjf ,
�
00 UPA
GROUP
NUMBER
OF
STORIES
I IEl 01
LL N,
IN.
CIUML F
U NIT
RITtCAL
A SAS A/14
NUMBER
SPECIAL "PECTOR I
ED
REOUIR C] YES
—A OfLCUPANT
LOAD
......... .
DESCRIBE WORK TO BE DONE
REMA KS
PROGRESS INSPECTIONS PER UBC 168/FINAL INSPECTION RECI
Aw UP
0
14y /17 ml-T3� . ....... .
ub ;z4,. EE
z
:C
Aid zj 1-7- 4
& /0
VALUATION
FEE
W3
HEAT SOURCE GLAZING % LOT SLOPS%
PLAN CHECK FEE
BUILDING
340
Z
9
0
m
PUUMBINC�,
PLAN,CHECK NO:
VESTED DATE
M ECHANICAL
T NOTED IS ERMIT COVERS WORK TO
ERIMIT .I..RlZ.. ONLY THE W --A.YC�N1HT.U`.'TIO..NT.EF LIC
BE .. E ON PRIVATE PROPERTY ONOLY.
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL RE IRE
SEPARATE PERMISSION.
IRIGING11ILL
SURCHARGE
00
PERMIT APPLICATION: 180DAYS
BAR�PROVIDED ORK IS STARTED WITHIN1800
PERMIT LIMIT. I Y W
EN
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ta
'AP " I CANTjCAJ.SEHALFOF 01 E1 SI.US�, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
tj
'PL HIS
IN NT.. R STON EMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
FROM ANY AND
ANOSCAPtN
2
EDMONDS. WASHINGTON ITS OFFICIALS, EMPLOYEES, AND AGENTS
ORIN
ALL CLAIMS FOR DAMAGES OFWHATEVER NATURE.ARISING DIRECTLY DIRECTLY
NOT BE
I NSPECTION FEE
x
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL
WAIVE OR REDUCE ANY REQUIREMENTOF ANYCITY ORDINANCE
PLAN CHECK DEPOSIT
ow
T
DEEMED TOMODIFY.
WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCc
P
RED I
—
I
N OR LIMIT IN ANY
T LE
ii,
THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
I
Tp—pu CATION
APPROVAL
I HEREBY ACKNOWLEDGE
INS OWNER. Oil THE DUlU`RAUTHCT`,1NZ.1D AGENT OF
GIVEN 11 CORR1CTjETG
Th, application I. act . pKant all .11ano bY in..,
C-ATPILY.
THE 0 AN. 'AGR OM WITH CITY AND STAT LAW E.U, 1; 'TRU
CALL
B.ilaing 0 2 opaty;aadF..a..pl
TION; AND Ii GOING THE WORK AUTHORIZED THEREBY. NO PERSON WIL L BE EMPLOYE%
TO
INSPECTION
n.IftL.La,hL,,,
: cNpj ja.cka;wf dFad in p.ca p-Ld.d.
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING
FOR
I � ".I DATE
WORKMENS COMPENSATION INSURANCE AND RCiW 18.27, ------- A
l�
�
OFF LAILIS111AT111
011i j DATE SIGNED
(425)
SIGNATUREIOWNE
(2-
Z
771-0220
MED Etl'
RELEA
EXT 333
ATTENTION
IT IS UNLAWFULTOUSE OR OCCUPYABUILDING 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, USC SECTION 109
FAX
PINK � OWNER GOLD -
----------
___ ------