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20000443.pdfr4loofe) _ - "ATE RECEIVED c_v\c'.�'w\ sr\—� CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNERNA �AMIOIEIIIINIIS 91 MAILING ADDRESS ZIP -14 \4� - C�D PERMIT EXPIRES USEE PERMIT �),OoWt ZON NUMBER JOB SU ADDRESS 9`� 1 () PLAT NAMEISUBOIVIS$ON NO, LOT NQ._) LID NO. LID EES PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP wV13—, So-, U.. I— Pea a EXISTING — PROPOSED — RE IREDDEDICATION— FT — ,, Iul.a METER SIZE LINE SIZE NO. OF FIXTURES PAV REQUIRED YES 0 No 0 ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE lz ITY_,__— ZIP, NAME ENGINEERING REVIEWED/OATE ADDRESS 41—pso FIRE REVIEWED By DATE CITY ZIP TELEPHONE VARIANCE OR CU SHORELINE OR AOSN IINSPIC�ION SO' YES 0 No 11'.ONTED D STATE LICENSE NUMBER EXPIRATION DATE _413 (z k"A�0,4 Ll 0D qNG eK46t4\ COMPLETE EXEMPT "'11.1"AlIA ALLOV E PROPOSED HEIGHT ALLOWED PROPOSED PERTY TAX ACCOUNT ROE—. -2_ NEW RESIDENTIAL PLUMBING I MECH cl LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS FRONT SIDE REAWR PROPOS ED SETBACKS (FT) FRONT LJPSIDE REAR I, 'K CM..G.IAL COMPLIA CE OR ADDITION 0 ..AN.. .1 BE 0 REMODEL APARTMENT SIE�N PARKING —F—LOTAREA REa. PROVIDED P E BY E G Cy. C] REPAIR 0 RAGING f X FT� RD DEMOLISH TANK OTHER ZI 0 AS' 0 RIIAI= WALL 0 AR RENEWAL 0 G�ARPORT FIOCK (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CHECKEDBY TYPE 0 F� �0,�!jTLCTION JCO__ OCCUPANT OF GROUP NUMBER OF 0 STORIES NUMBER OF DWELLING UN— CRITICAL AREAS It NUMBE SPEC, SPECTOR JAREA [RED REOUALINf_j YES OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING % LOT SLOPE I SU LOING AN CHECK NO: rlITED OAT' PLUMBING 100 \ � —,— MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL 1) LKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 2 OMAIN (CURBS'SIDEWA SEPARATE PERMISSION. RCHARGE :3 PERMIT APPLICATI N; 100 DAYS KI ENO. REVIEW FEES PERMIT LIMIF I YEAR - PROVIDED WOR A S STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FO MOREINFORMATION -APPLICANI HIS OR HER SPOUSE. HEIRS. A .. 6 1 NS AND S Es RS ENS. INSPECTION FEE ,�Qar,'EHA' FNDEMNIFY DEFEND AND HOLD LESS T E ITY A IR ES TO INDE.NIFY. BlIENG AND E F LANDSCAPING ;�ARP�L'�CA.NTjONGSERA" OF /00— NTSF AN AND INSPECTION FEE rl .4,noj M EDMONDS, WASHINGTON, ITSOFFICIALS, EMPLOYEES, I ECTLY R IN IS TLY PT Ns:ms A G — A `_____�HJS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT S F E OF RSQUIREMENTOFANYCJTYORDINANC ROM THE IS R EDUCEANY DEEMED To MODIFY WAIVEO BILITYTO ON, -0 NOR ED Ty� 0 LIMITINANYWAYT I EA ENFORCE ANY ORDINANCE PROVISI TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION� THAT THE A PLICATION APPROVAL RECT, AND THAT I A THE NEG. R THE UL AUTH RtZED A ENT OF h—ppli- ........ p,eaaau,atII.iga.dbyIh. a IVEN Is OR CALL 'd. T E HER, I A EE OPPLY ITH ITYANDSTATEL SPE U IN CONSTRUC- 1 011id.t.1hlea,., aty: ad Fees am pal Tj N; AND IN E K AUTK RIZED THEREBY. N PERE N ILL BE E PL YEO FOR INSPECTION _.ipt ...k—a. di—p... p.vld.d. 0 A r 1, VI LATI NO T L B 'ODE I THE STATE F ASHINGTON RELATING T TE RK EfTS 0 ENS IONINSURAN08ANDRC 18.27. OF ILSSIGNATURE SIGNATURE (OWNER OR AS NT) DATE SIGNED (425) 771-0220 EASEDBY AT EN [ON EXT 333 0 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL 771-0221 .10NAL-11LIE . YELLOW - INSPECTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- PINK -OWNER - GOLD, AS ESSOR CATE OF OCCUPANCY HAS BEEN GRANTED. LIBC SECTION 109 FAX a'.. z 9 � 1-1 0 a m c 0 1 m 0 0 c m m 0 m m 0 rl 0 o Fn c 0) ;l co mo z z m EINAL PROJECT APPROVAL EDEM TO' DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE - ENGINEERING DIVISION DATE - PLANNING DIVISION DATE PROJECT 5:t SITE ADDRESS, PERMIT 2-bo W&_ADB#______DATE INSPECT DESCRIPTION OF WORK TO BE INSPECTED---- -7S2,; S Y-\ A field inspection was conducted to determine compliance with approved plans. Final approval denotes that there are no objections from the above signed Department to the granting of: approval of the described work Bonds associated with the project may be released _GRANT FINAL PROJECT APPROVAL _GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED _--FAILED FINAL INSPECTION - OUTSTANDING ISSUES 2. 3. -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL ocaprvl.doc.i:temp:bldg:forms6/98 z M mo --1 0 0 0 m m z V) 0 -n m m C (J) K W M 0 z z 2 0 m RECORD OF INSPECTIONS.. INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing 0.� ............... 9 wait .................. . ....... Pier/Porch ............. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -in ................... Commercial Final HEATING: Gas Test .......... Gas Piping ................. Equipment ................. Commercial Final EXTERIOR SHEATHING NAILING ....................... FRAMING .............. FIRST FLOOR FRAMING INSULATION ................. Floor Insulation Wall Insulation ........... Ceiling Insulation SHEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS Z 0 0 0 M C Rill 0 0 -040 C MITI z 0 M M 0 0 C Mor z z z M ARE RECEIVED P ERMITEXPIRE'S USE PERMIT ;Looq%44,- ONE CITY OF EDMONDS ZONE CG NUMBER CONSTRUCTION PERMIT APPLICATION J66 Sul ' T' BDR ADDR ESS FSE I D NAMENAME OF BUSINES _ NO. LOT NQ. L' No� PLAT NAMEISUBDIVISION LA ? LID FEE $ 'sc: I ?7AILING ADDRESS I. P AR'- U PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP A,'� = F.", l 0 P.- ll 0 B 0 EXISTING- PROPOSE.- CITY ZIP TELEPHONE 0 REQUIRED DEDICATION F r - Y11- 0 LIN NO. OF FIXTURES PAV REQUIRED ME'ERSIZE LINE 11;ZE �T; Fr YES 0 NO 13 9 REMARKS ADDRESS FFFIN118LE FOR EROSION CONTROUDRAINA- R'Y ZIP T NE ENGINEERING /DATE FIRE REvIEWED6y_ DATE ZIP, TELEPH NE m , I __7FN__S�P_1_C!TION I D wvcn V-P- S SHORELINE OR ADBA 7�%_�ION PSO EXPIRATION DATE VARIANCE OR CU S ED , DO C STATE UC�5 BE NUMBER YES 0 NO SEPA REVIEW SIGN AREA EI.H I pROpETY TA�� ACCOUNT PAR COMPLETE I EXEMPT ALLOWED I PROPOSED ALLOWED PROPOSED CEL NO.k - I do 13 aa -C4 V EXP LOTCOVERAGE REQUIRED SETBACKS - PROPOSED SETBACK$ IFT) FRONT URSIDE REAR EW 0 PLUMBINGIMECH ALLOWED PROPOSED FRON T SIDE REAV 0 MPLIANCE OR ADDITtgo 0 COANGE OF USE J DBY D S REMODEL SIGN FENCE 0 IIEAAIFT� 0 GRADING CYUS 0 X FT) BEMOtt)H TANK o OTHER GARAGE C R BETA.INFINYGWAIL F1 RENEWAL A PORT ROC OF r (TYPE USE. BUSINESS U CH,,K,o By 01 CONSTRUCTION OCC PANT OCC ITYPI GROUP NUMBER UM L__I BER�Gf WE L NI-1- CA SPECIAL INSPECTOR JAREA 111, IT LOAD OF 0 STORIES el� R REQUIRED E] YES I z PESCRIBEWORKI" BED RE E.ARKS PROGRESS INSPECTIONS PE R UBC 1081FINAL INSPECTION REQ'D PLAN CHECK FEE U HEAT $0 CE GI-AZING % LOTSLOPE% BUILDING PLAN CHECK NO: VESTED DATE P UMBING za MECHANIC - THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO CI BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL LKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE DOMAIN (CURBS'SIDEWASEpARATE PERMISSION. SICOgbRCHARGE PERMIT APPLICATIONt 180 DAYS PERMIT LIMIT'. i YEAR - PROVIDED WORK IS STARTED WITHIN 130 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFOR ATION ENG. INSPECTION FEE 'APPLICANT ON BEHALF OF HIS OR HER SPOUSE� HEIRS, A SIGNS AND SUCCESORS IN INTEREST, AGREES TO NIFY. DEFEND AND HOL D HARMLESS THE CITY OF LANDSCAPING �ND 2 EOMONDS.WASHINGTON� TSOEMFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE ALLCLAIMS FOR DAMAGESOF WHATEV E R NATURE. ARISING DIRECTLY OR I DIRECTLY NOT BE RE I T, FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL REQUIREMENT OF ANY CITY ORDINANCE PLAN CHECK DEPOSIT DEEMED TO MODIFY, WAIVE OR REDUCE ANY CITY'S ABI�,tTy TO ENFORCE ANY ORDINANCE PROVISION.- RECEIPT NOR LIMIT IN ANY WAY THE TOTAL AMOUNT DUE 5s I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APF�K' ATIULNY, THAT THE INFORMATION 8 GIIRN IS CORRECT, AND THAT I AM THE OWNER AGENT .1 NST UC- G R LgS RAIT LAT1,11.1D - 6oTATT�HE To foMPL 'TH YA E E s W EQU N BE EMPLOYED TH OWN 'A0= CALL 11 . T H RKAy1W..I12!'T..TH1 EB NO PERSON WILL T' N A NO I - E W. RELATING TO FOR INSPECTION dm. -p-, 01 WAS R ... . STATEY HINGTON VIC OF E HE IN LAT ON T. LA. NSUR CE AN. RCW 111 WoRXM'N� S ��.MPENSAT.N' AN .27. OF 6 SIGNATURE ATE NTI DATE SIGNED (425) // 01) SiGNATURE(oWNER OR AD 771-0220 BY R EASED EXT 333 ENtION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 -INSPECTOR INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW GOLD - ASSESSOR A FINAL HAS BEEN GRANTED. UBC SECTION 109 V-V- FAX PINK . OWNER CATE OF OCCUPANCY 5�8