20000508.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
ERNAMEi AME OF BUSINESS
47V iZP AP ,�4 p—k 6 r-- 4WO
PERMIT EXPIRES
USE
ZONE
PERMIT
4b o's, 0 13
—NUMBER
JOB
ADDRESS �2q,.:jjj
S ITEJAPTI
S
PLA,T NAMEISUBDIVISION NO
I LOT 10-
-
11ID"FEoE_$-
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED
6-
CITY ZIP
E2�NE
REQUIRSDDEDICATION FT
SI-11 Rl 0
P VREOUIRED
.A IE
ea)48e: :5
YES 0 NO 0
ADDRESS
R MARKS
OWNEWCONTRACTOARE�l.tISIBLEI.�E�OSIONCONTROUDRAINAGE/C-S
_2/�/�
CITY ZIP �OLE
I-
NAME
0-1 'j'E 77
ENGINEERI�G REVISWEDIDAT
'?(�/ -�/ 7/110
ADDRESS
e4' -
FIRE REVIEWED BY DATE
CITY 0&
,
INSPECTION BOND
FRANCE OR CU
SHORELINE OR ADBI
RE .0
YE100,170
POSTED
0.9-9 1<6
SIGN] AREA
C3
EIGHT
TAX ACCOUNT PARCEL No
SERA REVIEW
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
PROPERTY
3 �-�_7 3 —3 —
EXP I
I
I f 4.5'
NEW
RESIDENTIAL
PLUMBING i MECH
T COVERAGE
DIN
ALL LOED PROPOSED
REQUIRED SETBACKS I
FRONT SIDE 11A(V
PROPOS 0 ETBACKS (FT.)
FRONTEURSIDE REAR
COMPLIANCE OR
&3
ADDITION
COMMERCIAL
0 CHANGE OF USE
AREA
PINNING REVIEWED
By DATE
0 REMODEL
APARTMENT
C3 SIGN
PARKING
PEO'D
I PROVIDED
LOT
REPAIR E3 GRADING CY.. 0 'FENCE X
IL�a
DEMOLISH TANK ci OTHER
'3"..
ci GARAGE r-1 RETAINING WALL
CARPORT ROCKS. C] RENEWAL
CTIVITY) EXPLAIN:
CHECKED
TYPE UCTION
CCU N
997� OGF.._p TR3
NUMBER N MBEROF CRITIC AL
SPECIAL INSPECTOR
AREA
OCCUPANT
DWELLING
SOT�ORIES UNITS .-NUMBER
A EAS ;2000-74/
REQUIRED E] YES
LOAD
I , 1— 11 )
7-6
9
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
ETC.) WILL REQUIRE
DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS. MARQUEES,
SEPARATE PERMISSION,
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT. 1 YEAR, PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPUCANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST. AGREES TO INDEMNIFY, DEPEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM AI'IYAND
A L Cl-AIMS FOR DAMAGESOF WHATEVER NATURE. Ly
L ARISINGDIRECT ORINDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
LICE ANY REQUIREMENT OF ANY CITY ORDINANCE
DEEMED TO MODIFY, WAIVE OR RED
D NOR LIM IT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
F
REMARKS
PROGRESS INSPECTIONS PER LIBC 108ITINAL INSPECTION REO'D
u-ewkL- LQscc'4 M55 V/
v L
'�Tpau-N - 9 1pyD auprvc-�
pe'tf 101
VALUATION
FEE
PLAN CHECK FEE
BUILDING
Ll
q -3a
PLUMBING
4-11,
MECHA141CAL
STATE SURCHARGE
ENG. REVIEW FEES
LING, INSPECTION FEE
cc)
LANDSCAPING
INSPECTION FEE
PLAN CHECK DEPOSIT
AECE"�/_'5 311-
L
TOTAL AMOUNT DUE
8ECEIPTIr
_.)
-7 IS. r
_)n
I HEREBY ACKNOWLEDGE THAT I HAVE HEAD THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE OULY AUTHORIZED AGENT OF
STATE LAWS REGULATING CONSTRUC
CALL
T j, p01 .1 �y Ih,
THE OWNER. I AGREE TO COMPLY WITH CITY AND
TION, AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERE N WILL BE EMPLOYED
RELATING TO
FOR INSPECTION
B.0d., Otj'_I .1 D-11 - FA- - P.Id.
wI,,d9. p-0 pl-ded.
IN VIOLATI ON OF THE LABOR CODE OF THE STATE OF WASNIO�GTON
WaHKMEN'S COMPENSATION INSURANCE AND RCW 111,27.
OF I IALS SIGNATUR!_-DATE
El �A�UWNER R ADEN
E SIGNED
(425)
771-0220
RELEASED DATE
ATTENTION
EXT 333
12,1 IM
ITIS UNLAWFULTO USI.R Or(DuPY ABLJILDING.R STRUCTURE UNTIL
771-0221
FINAL AND APPROVAL OR A CERTIFI-
ORIGINAL FILE YELLOW I'NSPEETOR
A INSPE CTION HAS BEEN MADE
CATE OF OCCU PANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK OWNER - GOLD ASSESSOR
5-
z
0
c: rn
00
c:
-j r
X rn
M Z
--i
—Z
-4
0)
0
n
M M
0 V5
0
rn
cg
M 0
Z
7-1
z
-4
x
CA
z
2
0
Ill
NOTICE 10 THE DOCUMENT IN THIS FRAME IS LESS CLEAR THAN THIS NOTICE
E QUALITY OF THE DOCUMENT.
IT IS DUE TO TH
A 14 N
Z0
10 1
I-zr, .
:13
cl,
q 71
-7
-"A-# C4
p sdy-,y op Oka
4L 0
A pa
. ..............
SCINONG3 -AD A113 =N SV IVAC, TVILMNION3
SaNOM39 A(YAIIO 813 SMAIIISIMMdontea
'613 SMA89S lNgYldO*SAga AaODkjlla
Cl-llz 0 1 AVW 0 Nw G- ON11833mutO
C3.3 A 1,�f 3.ZL,,. a3AI303U
9/1 1
10H.LMOD NOISO83
0 7,PW f 90VNIVU(3 (INV
BOA 3191SNOdS38 Sl HoDwiNOOM300
w.alu;ld WULW3110N
'30a
+
PdqwCvk&A'O� 71
7i9ZO
1 -02:��-Z427'
0,5 1 SS' � 7 - 7'
4VO5 Al"
7-Paf, 4 ZVO24 VC IMP
'DATE RECEIV�D
57/
PERMIT EXPI!,4qS
PERMIT
CITY OF EDMONDS
NUMBER
CONSTRUCTION PERMIT APPLICATION
'AOD80RE5S SUITPAPTN
Z 2, 5 �)d- Av(, v—).
OWNEFl_NAMEAIAME GF BUSINESS
PLAT NAME/SUSOIVISION No,
LOT NO, LID NO,—
(m rz
LID FEE S
MAILING AD SS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP W P.- R.q.0 d 0
0
EXISTING
CITY Zip
bEL9PNONE
A?n
REQUIRED DEDICATION FT
FIXTURES PRV REQUIR D
NAME
YES 13 NO C3
-t
ADDRESS
REMARKS
OWNERfCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
7—
-.2
'CITY
NAME
ENGINEERING REVIF�&I)19ATE
ADORES
DATE
z
2 1k!9,57,.:5 FIRE
REVIEWED BY
IT ZIP TELEPHONE
a#,
CU HDRELINE OR ADS. INSPECTIO ...
VARIANCE OR 3,
N POSTIE.
0
:KED BY
STATE LICENSE NUMBER
REO'D
C:3 YES. lafo
- HEIGHT.
SERA REVIEW SIGN AREA
9n
COMPLETE EXEMPT ALLOWED PROPOSED .,ALLOWED PROPOSED
p E I . V,_ — .
;�, �TAX OUNT Pll
7—�5.�pj,44-9' : :
-4
S m
1.4 3--3—
P .
0
P�UMRING I MECH ALLOWED
SETBAC S (FT) PROPOSED SE.TBACKS (Fr.)
LOTCOVERAGE 0 R IRE AV, FRONT UP DE -�EAR
PROPOSE R T SIDE RE
m
0
--1 0
7. I11z6.
0 N 350 ZI L5
COMPILIANCEOR f
0
-4
A:WTION CHANGE OF USE
PLANNING REVIEWED By
PAjK,lll LITA�EAOJ.
M
RENIODEL 0 SIGN RED., R.V.... p
M Z
NOE
RERAIR't, . 0 GRIIIII CyOS [3 FT��
c
> -4
DEMOLISH OTHER
�'.',E3: TANK
0
ci GARAGE'.� :RETAINIRNGWALL RENEWAL
LJ
0
CARPORT� POOXE Y
(TYPEOFUS', INESS R ACTIVITY) EXPLA N:
CHECKED4 I TYPE OF gONSTRyCTION 1C DO UPAkT
I 'GRGUP4';.
1�46
MITI
5F, if_IV
I
NUMBER NUMBER OF IIIETAICAL,��,e_ ��i 1112;p�ec TOI::T_ AREA 0 UPANIP,%'.
_0 -7 LOAD'
AR
0
OF DWELLING
STOR .2 NUMBER
yii
YES
0 y
0
ml
0
DESCRIBE WORK TO BE DONE Ih
a
g -
REMARKS
Won OGRESS INSPECTIONS EitUBC1081FINALINSP E�CT
P R
M
9 fllj9i7-,o,,,',l1_1_1�11�l(, fecf:v /6
"=EQ'D
:13F
1, ow.. V
-
7�
a,40,91Vi -�r6.
5-.P_U��PAC LLDV D L) A-2
M
>
z
I I" T*tv e4l c V_
(n
VALUATI.. FEE
z
�IAN CHECK FEE
BUILDING
m
HEAT SOURCE GLAZING %
LOT SLOPE'%.,�
PLUMBING
2
VESTS DATE
PLAN CHECK W0.1" to
FCHANICAL Ll 0
RK NOTED. THIS PERMIT COVERSUIORK TO
A.U,,TpH2O,,R,'AZTEES,ORNOLp'ETR"TE,W.,O.L � U,
A.,C..6TlUCTIOm.NTHEl �
3PIA01 CL
DOMAIN (CURBS SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
3 SEPARATE PERMISSION.
STATE SURCHARGE
2 '00 DAYS
5. PERMIT APP4ICWATIr6jN4j
PER IT LIMIT. I YEAR, PROVIDE 0 K S STARTED WITHIN ISO DAYS
END REVIEW FEE
SEE BACK 0 T FOR MORE INFORMATION
F PINK PEFIM1
FEE
oo
'AllllA&=F OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUC CESORS
ENG. INSPECTION
tj IN INTEI.. To INDEMNIFY, DEFEND AND HOLD HARMLESS HE CITY OF
9 EDMONDS. WASHINGTON ITS�FFICEIAES EMPLOYEES, AND AGENTS FROM ANY AND
ARISINGIS RECTLYOR IN
c AT V � NAT IS DI
NDSCAPING
INSPECTION FEE
RECEIPT
-396
ALLCLAIMSFORDA 'AGEjGF
THE ISSUANCE OF THIS PERMIT. ISSUANCE OF TH SHALL NOT BE
PLAN CHECK DEPOSIT
OPERMIT
FROM
I D EMED TOMODIFY. WAIVE OR REDUCE ANY REQUIREMENT FANYCRYORDINANCE
0 E CITY-SABILITYTO ENFORCE ANYORDINANCE PROVISION.*
NOR LIMIT IN ANY WAYTHE
TOTAL AMOUNT DUE
RECEIPT
(I
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT � A. THE OWNER, T, THE DU�L, AUTHOT1,1N1.11CIAGEISIT OF
ITHCITYAND NSTR
.. COMPLY,., B AT LAW RE.0 UC.
CALL
h" NPPI`
B�ijT -"ND.puI,:.�dF ... d—d
dmgollicl
NER I .RE
THE Wr LOYED
TIOND AND I� DOING THE WORK AUTHORIZED THEREBY. NO PERSON WLL BE EMP
OF WASHINGTON RELATING TO
:�,�hislh
o-pt knowl.dg.d I—P.- 0.11ded.
FOR INSPECTION
IN VI 6LATIGN OF THE LABOR CODE OF THE STATE
WORKMEWS COMPENSATION INSURANCE AND RCW 18.27.
(425)
OF IALS SIGNATURE DATE
'ct G
ENT)
DATE SIGNED
771-0220
-L'Lt mtli
RELEASED DATE
EXT 333
ON
UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
TOP
IT IS
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPE
GOLD - ASSESSOR
A FINAL
OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER -
CATE
S,qS