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20000544.pdfj OAT CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER MO�� BUSIV /0 1 I IP _e I 2- 63 0 9AL6 IT7 72lqY CITY ZIP IT11-111111 OE� - c j P16hi #tail"I'l Y,/�l AD[, S T�j?NE P illl DATE 14 1� , op I aEl vNEW f`jf UMENTIAl b/PlUVSIN.(Z.N�) 0 ADDIT ., C ... ERCIAL ' . .111AN.S.. 0 CHANGE OF USE 0 REMODEL APARTMENT 0 SIGN 0 REPAIR GRADING CYDS FENCE 0 1 X FI DEMOLISH 0 TANK Ej OTHER C] GARAGE CARPORT RETAINING WALL 0 ROCK -T 'F FEN 111ITY1 EXPLAIN 1�&� � 12A NUMBER S. NWELLINOF C ITICAL AREA. OF STORIES Urie" NUMBER DESCRIBE WORK TO BE DONE SLOPE % THIS PERMIT AUTHO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK I R I BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC E DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS . MARQUEES, ETC.) WILL REQUIRE 5 SEPARATE PERMISSION. P.NMITAPPLICATIO : ISO DAYS P PERMIT LIMIT. I YEAR - ROVIDED WORK IS STARTED WITHIN ISO DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATtON 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESOR AG EE 1NDEMNIFY. DEFEND AND HOL HARMLESS THE CITY 0 REST. SH P S T 0 1 , SMPLOYEESSAr DENTS FROM ANY AN CIALS 0 0 - A INGTON TS OFF1 URE ARI IN R-1 EDM CLA S W R M F TEVER NAT I S FO DA AD E 0 WHA CE OF T PERMIT SHALL NOT B ALL M T M SS C E IS PERMIT I SSUAN FRO E I LAN OF rH DUCE Y FEQUIREME1 I. _ " nTQ MODIFY WAIVE OR RE AN F ANY CITY ORDINANC ____1 e4iii, -7, PERMIT EXPIRES f PERMIT t7c� '�SE ZONE NUMBER JOB SUIT11APT, AODBW PLAT NAMEISUBDIVISION 77__["�� Ll DINO LID NO, LID FEE S I'D FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXIII TING — PROPOSED . REQUIRED DEDICATION— FT — c TESCP App-1 13 IS s p App' 11 P- s r - I P. col P. her' R.r." ..... CI . d ". 0 UM.,I—rd PRV REQUIRED YES 0 No E3 REMARKS RD OWNERICONTRACTOR RESPCNSIBLE FOR EROSION CONTROUDRAMAGE W ENGINEERING REVIEWEDIDATE FIRE REVIEWEDBY DATE I RE EV ' EWD By r NCE OR CU VARIANCE OR CU R IA VAR SHORELINE OR ADB# INSPECTION E 'D R a E3 YES ONO IPBOND "TED VI B E A F[ IEW COMPLETE I EXEMPT X P FE_ SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED C T LOT OVERAGE TC C P ALLOVYE PROPOSED REQUIRED SETBACKS (FT.' FRONT SIDE REAR PROPOSED SETBACKS JM. FRONT URSIDE REAR —T—LOT PARKING REO'D I PROVIDED AREA7 PLANNING REVIEW EDBY DATE R R R S E A K OF �ST CTION 'C C R E50 C OC $PEC LINSPECTOR jl�ARE RED Ri EQL�JA A LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL IN5Vb:U I 1UN n=U 11 VALUATION FEE PLAN CHECK FEE BUILDING PLUMBING MECHANICAL 0 GRADINGWILL STATE S URCHARGE ENG, REVIEW FEES o 0 LANDSCAP 0 INSPECT?ON FEE E PLAN CHECK DEPOSIT E RECE PT 0 RDINANCE PROVISION, TOTAL AMOUNT DUE RE ' --79,,<— 1 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICAT;ON; THU THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT, A D THAT I AM THE OWNER. 08 THE DULY AUTHORIZED AGENT OF T i, eppli h.t . permit imil r,ahld by the THE OWNER. I AG RSENTOCOMP WITH CITY AND STATE LAWS REGULATING CONSTRUC LYJTHORIZE E MPLOY ED CALL Bii�j dllg 011111-111 hIllhOl D.P.ty: Ild F ... ... p,,d,.,d T�i D THEREBY, NO P ERSON WILL BE E OF THE TATE OF W.NINGTON RE ATIMG TO T.- L m FOR INSPECTION ged rp.c.pmvid.d, O-INGT.E 1= ... wo KME , COMPENS=2ANCE AND RCW IS... 7. FICIALS SIGNATU DATE _T.NAT)i�E (OWNER 7ATE SIGNED (425) f __�_ V4�_7 /1-2 771 �0220 RE EASED By . TE EXT1333 W-ffE—NyfON IT IS UNLAWFUL TO USE 08 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 AStiESS.N 5�8 z 0 0 M ca 171 0 80 c M ITI 0 -TI -4 M M 0 0 C c co M 0 Z z z 2 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED r SETBAC KS ..................... FOUNDATION: Footing .............. Wall.......................... Pier/Porch ................. Retaintrig Wall Stab 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 '"h"%V.II Insulation ........... Ceiling Insulation SHEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. TY)s "sqq Z M —I -n 3: M C M 0 -4 C). 'K 0 C X rn M z C 2 > 0 3: IT, rn 0 0 Fn C (j) z z M DATE REcf-lV7 ERMIT EXPIRE§ Fp USE PERMIT f'lTv nr i=nRAONDS ZONE NUMBER CONSTRUCTION PERMIT APPLICATION JOB AUDIII-12 !3,- "�U-D Sul PT. OWNER N&NAME C�F BUSIN VISION .0 PLAT NAMEISUBDIVI SION LA NA E' LID NO. ant Mrs; LIDFEE$ PUBLIC RIGHT OF WAY PER 01 FICIAl I GHT OF WAY PER C UEL C STREET MAP TE11:AP AW P �11-.=Pll CO3 ZA,,./r lTq 21 P FS .P OSE._ S I F SO E X T. XISTING AT SECURED ... ICATI. FT u NAME ADDRESS CITY NaE I , 0 M ADORE S h 9,03 M METER SIZE LINE SIZE I NO.OFFIXTURES Y�IRV s C3 'REMARKS W1111r.-TRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINA - c 5/', — FIRE REVIEWED By DATE T �j?NE EXPIRATION DATE c KED By VA RIANCE DR U SHORELINE OR ADS. IN�,P�EC OTION D 0 YES ONO '10 #t SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PR PERTY TAX ACCOUNT RCEL NO. PR PERTY TAX ACCOUNT EXP —V.EW LOT COVERAGE REQUIRED SETB KS I PROPOS DSETBAI [�/FLUMBIN. ALLOWED PROPOSED FRONT SIDEACREA(V FRONT LIS SIDE 0 ADDITION o C MPLIANCE R CHANGE OF USE I I - PARKING LOT AREA REVIEWED By DATE 0 mc, FIE DEL 0 SIGN 7NING D I PROVIDED , REPAIR GRADING CYDS 0 FENCE I X FT) RE-R- 0 DEMOLISH 0 TANK 0 OTHER oGARAGE CARPORT 0 RETAKI�NINyl WALL P., 0 RENEWAL 0 A ACTIVITY) EXPI-AIN: c JT�T;FCC SUCTION CHECKED By Cqj G2.UplAVS 0 E NUMBER N UMBER OF D WELLING AREAS SPECIAL INSPECTOR ILI..ACDU-.T OF 2- STORIES UNITS 1 NUMBER JAHEA REQUIRED 0 YES DESCRIBE WORK TO BE DONE 4 ------- IT— REMA KS PPtnrRr'S INSPECTIONS PER UBC 1081FINAL INSPECTIOI VALUATION I FEE PLAN CHECK FEE PLAN CHECK FIE OLA ZING LOT SLOPE I BUILDING PLAN CHECK NO: r 11TED DATE PLUMBING MECHANICAL 00 HIISIPE.MIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO NLY. ANY CONSTRUCTION ON THE PUBLIC E ONE . PRIVATE PRDPERTY 0 1 GRADINGfFILL E DOMAIN (CURBS, SIDEWALKS, DR, VEWAYS AROUSES. ETC.) WILL REQUIRE IDIRECTLYOR 1 3 SEPARATE FER�IsMslol`L TATE SURCHARGE C I PERMIT APPLICATION: 181) DAYS PERMIT LIMIT. I YEAR PROVIDED WORK IS STARTED WITHIN 160 DAYS ENG. REVIEW FEES I T SEE BACK OF PINK PERMIT FOR MORE INFORMATION 0 P PLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, AE51GNS AND SUCCESORS A �A NO R.L. ARMLESS T. E CITY OF N INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESSIRE L"I 'ESS AN. AGENTS So. ANY AND I EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND IINDIRECTLY RISI� G TL�. LI'S TLY ALLC MIS FOR DAMAGESOF WHATEVER NATURE. AR13ING BE INSPECTION FEE RECEIPT RECEIPT THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALLNOT DEEM D TO MODIFY. WAIVE OR REDUCE ANY REOUIREMENT OF ANY CITY oRDINANC E ENFORCE ANYORDINANCE PROVISICN,' PLAN CHECK DEPOSIT "P, IRECCIPT NOR LIMIT IN ANYWAYTHE CITY'SABILITYTO TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT; HAVE READ THIS APPLICATION; THAT THE INFORMATION �pI PLICATION Ap PROVA i GIVEN IS CORRECT, AND THAT Am THE QWNER. OR THE DULY AUTHORIZED AGENT OF CoNSTRUC d THE 0 'T' COMPLY WITH CITYAND STATE LAWS REGULATING =1.� WILLEIS EMPLOYE C CALL BWd,,,g Olki.1 .1 h,lihll DoPuIY: �,,d F..� - p1d. T'.N. WORK A.TH.RLZEOTH.RTg.Y6.O PERSON THE LABOR .DE OF THE STA , WASHINGTON RELATING TO FOR INSPECTION o,,,pt i, ,k ... Ild9od il $PaCG P-d- I T� �oF v VI. �ow E MPENSATION ,.B M FICIALS SIGNATUM?'% DATE rNCEANDRCWI8.27. s(T ATE SIGNED (425) 1 o 771-0220 R EASED BY 7A—TT—EN7- EXT1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 —INSPECTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL 'ILE ELLOW CATE OF CUPANCY HAS BEEN GRANTED. LIBC SECTION 109 OC FAX IA17 PINK OWNER COLD ASSESSOR 5198 z 0 d 0 . . X M M a - . --1 0 0 0 M In o Tn n M In 0 o Fn C 0) c co rn 0 M z z 2 0 M