20000489.pdfE
DATE FECEIV,D
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
PERMIT EXPIRES 440
ZONE PERMIT
NUMBER 200499
SUITE/APT#
ADDRESS Rif— 's
PLAT NAMEISUBDIVI$ION NO, I LOT NO. L
L�D NO.
D FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED �
Ty. ZIP ITIIEP"OIE
Eo,b tjtg!5 LA/A
_ tN�ME
A DRE
�S E7S
l
C TY ZIP JTELEWj�
REQUIRED DEDICATION FT
METER SIZE LINE SIZE I lo,ollIXTURII p RV REQUIRED
YE 0 NO 0
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAl— t
NAIVE
1 0 t 6--
ENGINEE?
REVIEWEDIDATE
ADDRESS
FIRE A VIEWEDBY
DATE
zip TELEPHONE
If
-160-ZO f4v,5.-7-75, q
OR CU SHORELINE
OR ADB# INSPECTION BOND
EXPIRATION A. � — .
VARIANCE
REDID POSTED
0 YES 0
REVIEW
SIGN AREA HE IPT�.PoS.
SEPA
COMPLETE EXEMPT ALLOWED PROPOSED All.WE
P CEL NO.
PR0P5ATY4X
!�CCOUN -7,5 - o Z 0060-1
EX�
I
NEW 0 PLUMBING NEC.
LOT COVERAGE REQUIRED SETBACKS (FT) PRO)PNOTSEDSETBACKS(ET)
ALLOWED PROPOSED FRONT SIDE REAR PH( UP BE REA
C MPLIANCE OR
XA.DITION Cl CHANGE OF USE
PARKING LOT AR
ED By E
REMODEL C] APARTMENT SIGN
REDD I PROVIDED
C] REPAIR 0 FACING CYCS )@(,FENCE
&Z X
C] DEMOLISH C) TANK OTHER
GARAGE �,ETAKIN
CARPORT Go '2� WALL RIMEWAL
2 (TYPE OF USE, BUSINESS OR ACTfV
CHECKED By ITYPEf
CUPA.;4�
ROLF
NUMBER N MBER F CRITIC L gotJE3�
OF D ELLIN AR S
SpEoC
UALEINSPECTOR JAREA
RE R
LOAD
NUEA
0 STORIES I IT. UMBER
yes
DESCRIBE WORK TO BE DONE
REMARKS
INSPECTIONS PER UBC 1081FINAL INSvtu I'v. Hic.
Cli 71VL& 5,n,`M PLV4r- F'-'4C(91
PROGRESS
T6 F-UN ~),J(:l qt" A�IC-
el'al) tr ij IL4— usT 7m)
rg'
AU-6-( , e --�ajr"
VALUATION FEE
AlAZY If ")7z 0011SIF,
PLAN CHECK FEE
j3e�5r 4.0,K,
HE TSOu RICE z10 I
BUILDING
A
PLAN HECK NO: IE51`10 IAITE
'S
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTIONON THE PU BLIC
GRADiNGIFILL
BE
DOMAIN (CURBS, SIBEWALKS. DRIVEWAYS . MARQUEES. ETC, WILL REQUIRE
m SEPAAATE PERMISSION.
I:
STATE SURCHARGE
PERMIT APPLICATION! 18D DAYS
-7 01
F. PERMIT LIMIT: I YEA. - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG REVIEW FEES
SEE BACK OF PINK PERMiT FOR MORE INFoRMATION
/7q il
TAPPLICANT. ON BEHALF OF HIS DR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
FY DEE ND AND HOLD HARMLESS THE CITY OF
ENG. INSPECTION FEE
LANDSCAPING
IN INTEREST. AGREES TO INDEMN
MILoy A ENTS FROM ANY AND
EE ES,AND G
EDMONDS. WASHINGTON. ITS OFFICIA LS. E
INSPECTION FEE
2
F
< ALLCLAIMS FOR DAMAGES OF WHATEvE NATURE. ARISING DIRECTLYORINDIFECTI-1
THIS PERMIT, ISSUANCE OF THIS P EMIT SHALL NOT 31
IIAN CHECK 0
�Ell
(1
FROM THE ISSUANCE OF
DEEMED T MODIFY. WAVE OF REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
ol Y ORDINANCE PROVISION --
0 NORLIMIT NANYWAYTHCIITYSABILITYTOENF.ORCEA�y�'_
RECEIPT
TOTAL AMOUNT DUE
I IFIE�IEEIY AC R AVT.R F.A IRS A P.IU�AT ON. T HAT T H E I N F 0 R N AT 1. N
tPP ICATION APPROVAL
WDT
N DULY AUTHORIZED AGENT OF
EBM TT.HAJ,
:N I R E .
GIVEN I A. E
GIVEN I
EN
YEN I
.,YEN I
'VE I
C'V I
C. Mfi No STATNL.AWS REGULATING OONSTIUC
CALL
......
�d.
., , G EE
TH �E,
THTHE _yW,,,,CTyA ER�F, E
C P RSONWILLL BE ENFL E
RILATI oyTo
"ON a., , P, 'UTHOR"ED TH NO 0
FOR INSPECTION
.,.PtUllk-.11d9ld—P. G I Y
IN N oik DANCE THE STATE OF WASHINGTON
C E AND FCW 1-21
lFIcl SIG RE E
'16
OR N N UP
(425)
--D
a)
DATE SIGNED
P,
771-0220
FELE QBY DATE
ON
—iV
EXT 333
OD
/o7)
ATjkN
USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
IT IS uNN,6WFULTO
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL. 'ILE YELLOW IASPECTOR
A FINAL
OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK OWNER - GOLD ASSESSOR
CATE OF
S198
Z
=i5i
0 M
c
m
0
0
MT
c -Z
E:
4
o -n
m M
a
0
o Fn
C (n
r. 0)
mo
Z
cl)
Z
0
rn
imas
77
TO:-74-811016-
DATE: 1,R- 7 -0'
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: DEPARTMENT DATE
I ���Wip�j,�_ENGINEERING DIVISION DATE �qofoo
V , —.M.o -
_____--YLANNING DIVISION DATE —
PROJECT
SITE ADDRESS -
PERMIT ADB#__-----PATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECT
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:
inal approval of the described work
Bonds associated with the project may be released
___/_(GRANT FINAL PROJECT APPROVAL
__GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
1 .
____YAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
___—RE-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvl.doc.l:tenip:bldg:fonns6/98
z
9
0
M
q:fi
C:: M
ma
--1 0
0 0
C
m M
z
o -n
n
M M
0
0
0 M
C U)
9 Cn
M 0
z
z
--4
c')
z
.0 1
0
M
RECORD OF INS PECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
5
In
J,
Retainlrig Wall ...........
Slab Insulation ..........
PLUMBING:
M 0
0
—I C.)
,
Underground .............
0 C:
Rough -in .................
ITI z
Commercial Final
>
HEATING:
Co
Gas Test . ....................
0 -n
n
Gas Piping .................
M M
Equipment ..........
0
6 Fn
Commercial Final
EXTERIOR SHEATHING
ITI 0:
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING
Z
INSULATION ...................
Floor Insulation
ca
z
Wall Insulation ...........
Ceiling insulation
M
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
71, &-, t
. .............
voe
?MlIv--AlE RECEIVE
tool it-li
no 10
PERMIT EXP RES U
115 too..
PERMIT
200499 V1
ZONE
CITY O� EDMONDS
NUMBER
JOB
CONSTRUCTION PERMIT APPLICATION ADDRESS
� 174JX SUITEIAPT#
OWNER NAMENAME OF BUS NESS
P T NAMEISUBDIVISIOIN NO,
LOT NO
LID NO.
t:*, 'k-e--r
11. FEE S
1. MAILING ADDRESS
PU%IC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Appl-d
I W P-11 R-1- D
P.- 0
0
CITY ZIA TELEPHONE
-...-rING- PROPOSED-
M-In"It.21 col
4, 60 V3 (0
REOUIRED DEDICATION
IT
. , E3
PRV
NAME
METER SIZE I
LINE SIZE
NO. OF FIXTURES
RE.UIRED
YES C3 NO 0
ADDRESS
O=CONTRACTOH RESPONSIBLE
R ERO
CITY
ELEPHONE _7
Ll
Wall a 9mew
NAME
t h 1,
91
ze.
E I G'l NeE E R I
REVIEWEDIDAT
�5; �S-
ADORESS --'V
0
6/
DATE
-zip
FIRE RdVIEWEDaY
CITY
TELEPHONE
0-u--j I
'I-L-s
-WRIANCE OR CU SHORELINE OR ADEN
INSPECTI ON
BONO-
z
STATE LICENS VEEP
R EaD
[JYES ONG
POSTED
0 1
LAP,
SEPA REVIEW
SIGN AREA
HEIGHT
0
COMPLETE EXEMPT ALLOWED PROPOSED
ALLOWED PROPOSED
m
. .
j-pT0-pERV4;;CCOUN PARCEL NO.
II s 6-7,;-
EXP
t�,
I I
/RESIDENTIAL
LOT COVERAGE REQUIRED 62TEACKS (FT)
REAR
PROPOSED SETBACKS (FT.)
FRONT REAR
0 NEW
0 PLUMBINGIMECH
ALL FRONT
OWED PROPOSED
SIDE
-�VDS
)(A..ITION C] C ... ERCIAL
0 C PLIANCE on
CHANGE OF USE
z
c
m
'PARKING
LOT An
EDGY E
REO'D PROVIDED
0
REMODEL APARTMENT
C3 SIGN
I
0
c:
x
REPAIR 0 GRADING
CYDS
REMARK.
M
DEMOLISH C] TANK [3 OTHER
m
10
C=
-E RETAIN GWALL RENEWAL
cl [3
>
C-.�IIAOFT FOCKP��
TYPE 01 U�;lll 0 R ACTI
:V-.m
CHECK5DBY TYPE
0.
Oc
�-uupp`W3 I
ri)
Mz,
ffF
0
Nr S�W
OF
NUMBER OF
DWELLING
CRITICAL
A EAS aodw
S CIALINSPECTOR
AREA
.UPA.
LOAD
-n
OF
c, STORIES
U-I "g;;`
NUMBER
REOUIRED 0 YES
-6E-SCRIBE WORK TO BE DONE
REMARKS
PER UBC IGOIFINAL INSPECTION REQ'l �9
m M
a
PLf-04
PROGRESS INSPECTIONS
0
rn
61' IM-J- ZeWry-
-f-m "vic I 4r-
c
mo
A-LaJ(q
Z r-
7z'
AT
X
r
z
la.09(cl f)j)LJS67,
PL
—
HX/�UFCE I
BUI-N.
ui
z
PLAN CHECK NO: 00 VESTED DATE
PLUMBING
0
MECHANICAL
m
ZE N HE WORK 'OTED THIS PERMIT COVERS WORK TO
THISPERMIT AUT-ORI S 0 Ly T
ON THE PU BLIC
T , T, ONLY CONSTRUCTION
E DONE ON PFIA E In 'PER ANY E C. L REQUIRE
.AN (CURES ., DEWALKS . DRIVEWAYS. ARDU ES,ET )WIL
GRADINGIFILL
:3 SE,�FATE
apfflIftURCHARGE
PE RMIT APPLICATION: 180 DAYS
R I IS STAR TED WITHIN 180 DAYS
PERMIT LIMIT'. I YEA �PROVIDEDW RK
ENG REVIEW FEES
-7/1
M
SEE BACK OF PINK PERMIT FOR ORE INFORMATION
'.p0.UDE ASSIGNS AND SUCCESORS
w -APPLICANT. ON BEHALF OF EN
Ft.
ENG, INSPECTION FEE
I, EMRFHER
13 .E XND C, HA RMLESS THE CITY OF
IN INTEREST. AGREES TO IND .
EMPLOYEES. AND AGENTS FROM A14YAND
LANDSCAPING
INSPECTION FEE
EDV ... S WASHINGTON, ITSOFFICIALS.
ALLCLAIMS FOR DAMAGESOFWHATEVER NATURE. ARISING UIRECTLYOR INDIRECTLY
REC
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
ORDINANCE
PLAN CHECK DEPGS$T
I
m VE OR REDUCE ANY REOUIREMENT OF ANY CITY
DEEMED To MODIFY. WA
YT E ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
RECEIPT
0 N RLIMITINANY jITY-S
TOTAL AMOUNT DUE
I HEREBY ACKV LE ETHA I THI.S. Al�,TLICIATIIDN: THAT THE INFORMATION
APPLICATION APPROVAL
NA �,:, AHAVTHRE.A�D
GIVEN ORR T. A T A. E NE 0 DULY AUTHORIZED AGENT OF
CITY AND STATE LAWS REGULATING CONSTRUC
CALL
TIN, IPPI-t- p.,.il u�lfl .,,.d �y
ofr,e,.l o, hol puI,:.�dF....,d..,.d,,,d
h,Z
i L
THE 0 N IA EE C LY WITH
A FEy, NO ERE.N WILL B
TION D 001 H AUTHORIZED THE E 'IMPLOIED
RE ATING TO
,�t
FOR INSPECTION
8"1 I,
v,
,I,,pj,-lk-I.d9ldillp- 10 1.
H C E STATE OF WASHINGTON
IN vil CODE 0 TH
I
Won M N: P N I URANCEANDRCW18.27�
OFFICII SIC RE D E
SIGN TU E( G
DATE SIGNED
(425)
I
1
771-0220--
RELEFIEY DATE
_j
to
-AWkNVON I
EXT 333
TO US E OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
'ORIGINAL
IT IS UOL,6WFUL
HAS BEEN MADE AND APPROVAL OR A CERTIFI-
- FILE - YELLOW - I�SP5CTOR
A FINAL INSPECTION
BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
Cy
CATE OF OCCUPAN HAS