20000629.pdfCITY OF EDIVIOND6
CONSTRUCTION PERMIT APPLICATION
OWNER NAME /NAME OF BUSIH�2;4_Ap
C 1441 s
M1LI"G ADDRESS
17 1-7 PL 14
CITY TELEPHONE NUMBER
FFbIZO 1164-0 flibv�g HelvL-no"'ic
ADDRESS
69
CITY
;C;�CINSE NUMBER 1: DATE
j�T
OP-14 104
Legal Lrescription or
ig�c Ude all easements
Fe—, L
o
6/
PERMIT
NUMBER
n
EGAL DESCRIATI ON CHEC]SUBCIVISION
SU' NO
ID NO
PUBLIC FIGHT OF WAY PER OFFICIAL STREET MAP
I IHGH
U 6 L C A E
T OF W Y
EXISTING —REQUIRED DEDICATION
A I T N G E U RR oF
PAO POSE
A o P o S ED
TESCP App,—d
Rw A-,- ftq-ed
SI-1 ol. P.I... R�
R-
Sl� ... 1k
13
o
13
13
METERSIZE
LINE SIZE
NO, OF
PAY I.EQU.1—
YES
EMARKS
R E ARKS
EENGINEERINGMEMO
DATED
REVIEWED By
FIRE MEMO DATE.
I
REY—MY
.... . ...... .
' I --- - I
SERA REVIEW SIGN AREA
COMPLETE I EXEMPT ALLOWED 1PROPOSED ALLOWED
EXP I
OVERAGE RED IRED SETBACKS (1- 1.) 1 PROP- G
1ALL0'—^W'EDC'j PROPOSED FURONT SIDE REAR FRONT U
ITPi-m'4e1-Nt-
60W 0-0�— UZI,
_3
PL Me
PLUMB
P'
NEW RESIDENTIAL ED
REMARKS�
A E
_rL4t_Q,
"MB
A NCE OR
C MPLIANCE 0
Cc MAL
COMP. 0, USE
CH ANG
El COMMERCIAL CHANGE OF US
o
0/.I.TI.N
APT. BLOr ESo
HE. DEL
GRADING NCE
0
C 14ECKED BY TYPE 01 COI
E
15�i
REPAIR CY.S LFENCE
_�4
W, P. L
0
WOODSTOVE S WIM POOL
j
Pi �OCACUPANT
A
S EC Lo
DEMOLISH , TUA.'SPA
lN.ERT 01 Tue..
E.1
AE.,
GARAGE PETAIIiINGWALL/ RENEWAL
.-T RENEWAL
M,
MARKS
CARPORT ROOKERY
A
C-�jE
I
PROGRESS INSPECTIONS PER UBC 108
PR
0
ES
(TYPE OF ACTIVITY) EXPLAIN:
T"E OF
r
NUMBER U !BER OF CRITICAL
owl LL He AREAS
OF
STORIES 'NITS NUMBER
z .0 C
.N A.
GEED WORK 000
DESCRIBEWORKTOB DONE (ATTACH PLOT PLAN) 4-
A _e_.
&im Ra� e-
...... INSPECTION REOUIRED
P T,
VALUATION
FEE
PUN CHECK FEE
"(;L STU& .104
BUILDING
HEAT SO`C GLAZING
G`E
PLUMBING
Plan Check No.
MECHANICAL
0
This P rm it covers work to be done on private property ONLY.
GRADINGWILL
Any construction on the public domain (curbs, s1dewallis.
driveways, marquees. etc.) will require separate permission.
5 RCHARGE
P m:Appll llon:118010aye
STOP. DRAINAGE FEE
P= Llmflt:�l Year - Provided Work Ili Started Within 180 Days
"Applicant beha f hi:.ortohei rspou S. h air$ assigns and
0
ndemna�, del� no and held
EN ANSPECTION FEE
Bs.r. i�oin
rter..�!
SU �girs
harmless the 'y I monde We h officials.
C�ng'.n
3 a m P� %eri',S frE.d. any �nd all ams iortisamages
Ina 'arising
of
"uIrl
directly or Indirectly from the Iss'
Wha Began
B�Y:a shall not be d ad
-a
to PLAN CHECK DEPOSIT
0, ,�s pEam,.,..,ESUgnc: ai�fyhla permit
y IV re r ance
modi equirement of any city ordina
any Ord n
nce DUE
0 nor llr�it in any way the City's ablIlty to enforce
TOTAL AMOUNT
provision."
'a 'he I he,. mad Ihl- applicali n; that the ATTENTION APPLICATION APPROVAL
I herebynacknow�:d Oor
d ",.I I . a 0, the duly
inI.r I . gi,.n correcl� an m th own
authm d agent of the ownerlon "a to comply with city and THIS PERMIT This application is not . permit until
orize ag
- AUTHORIZES h
state laws regulating construct , and In loin, the work authoriz slned tdaiBut.dring Offici.1 Or his/ at
0 LY THE
or
I WORK NOTE 0 . an as PA nd receipt is
ED thereby, no ip.'�cn will be employed in violation of the Lab 0 ,UY�y id
on relating to or men's Compensa.
Code or the Statec acknoWiRdked In space provided.
qS
tion insurance EI4 INSPECTION
7.
SIGNED EPARTMENT
TI �,—E
CITY OF
EDMONDS
CALL FOR FFE� F-,En By
ATTENTION INSPECTION
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE __ YELLOW — Inspector
1' 111-0220 — Flie
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL
UNTIL
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109 PINK — Owref GOLD — Assessor
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ...................
FOUNDATION:
Fooling ....................
Wall ........... ...........
PleriPorch
... .......
zi
RetainingW&II ............
Slabinsulation ...........
PLUMBING:
-n
'0
Underground .............
(J)
IT
c
i
Rough -in .................
TRIO
-40
1 P"',
CommercialFinal ........ ;.1
0 co:�
HEATING:
M
ITT
10
1
all,
GesPiping; ...............
Equipment ....... ......... .
n
_5
Commerciall'inal .........
M
-EXTERIOR SHEATHING
M
13 vi�
i
NAILING ............
FRAMING ....................
c
011
ITI
INSULATION:
Flocrinsulation ..........
Wall Insulation ...........
Ceiling Insulation .........
SHEETROCK NAILING ......
SPECIAL INSPECTION ......
0
MISCELLANEOUS
APPROVAL
FINAL
FOR OCCUPANCY ..........
4-0
CITY OF EDMO"S
CONSTRUCTION PERMIT APP
]OWNER NAMEINAMEOF BUSINESS .
0
OWUSE
4 N PER IT
F NU BER
'o B_ I a UITEIAPT.
B 2
A BE!
L
TELE;�LIUI
NUMB R
171-71
EXPIRATION
'a)(Acc—t
(a
I —I N.
El NEW
RE51DENTIAL
IL..B ED.
BIT:
COMMERCIAL
I
C.MFLj
RE..
REPAIR
APT.'BLDG.
T BLDG
P�
SH,
_F-1 FENCE
1RAD11G, C,CS
D41OUS1
WSOBSTOVE
'OERT
SAIMPOOL
HOT TUENSPA
E] GARAGE
ARPOFT
RE NING WALIJ
TAI
ROOKERY
_] RENEWAL
F
NUMBER OF RITICAL
.W"L�NG A
UNITS I JC .
INE (ATTACH PLOT PLAN) 51 0C
G4,; Fug- - AM. &
GR-Aef- WA-7VP- *A
WQ S71,1 N 9N5�-�T
AA GLIZI16
PUBLIC RIGHT OF
WAY PER OFFICIAL STREET MAP.
TESCF App,.— [3
FIN P-11t R,I 0
EXIST11 0 —
REQUIRED DEDICATION
S,,., L,. FI, F. 1, 0
PROPOSED
sde.,: � R,q,l,,a 13
NIETERSIZE
LINE SEETO.
OF FIXTURES
PRY REQUIR 0
I YES 0 NO 0
VARIANCE CU
SERA REVIEW
COMPLETE I EXEMPT
EXP
ADB
SIGN AREA
ALLOWED IPROPOSED
SHORELINE N
HEIGHT
ALLOWED JPROPOSED
LOT COVERAGE
ALLOWED I PROPOSED
REQUIRED SETBACKS (FT)
FRONT SIDE REAR
PROPOSED SETBACKS (FT.)
FRONT UR SIDE REAR
LOT AREA
i�
DATE
REMARI
C HEc9ED BY 5,TRUCTtON
100U NT
GFVP_
SPEC
RED,
]0
CCUPANT
LOA
REMARKS
PROGRESS INSPECTIONS PER UBC 1108
FINAL INSPECTION REGUIRED
PLAN CHECK'FEE
I'/II' PLUMBING
e C k N 0
Plan Check No.
P I a n C h
A
MECHANICAL
H A
/1,31 Liu.)
r k 0 b a a I a 0 a r I 0 N L Y
-fhis -Permit covers work to be.done on private property ONLY.,
T h P a r in I I c 0 r w 0 I P y
A N F L
ORADINGIFILL
b C u r 2 a I If a w I k 3
Any construction on the public domain (curbs, sidewolks,
A IT y G 0 IT a r u I 0 n 0 n I IT p u
"C
a r a I a a r In 0 n
driveways, marquees, etc.) will require separate permission.
d w a a In a q u a a s a w p
is
F
CHARCIE
S C H A
D
mh A P' I ce 0 I ao D y
Permit Application: 180 D9yB
P I P
M D A IN A G E F E E
STORM DRAINAGE FEE
To N
P v I ded W I 'IT I n
Permit Limit: I Year - Provided Work Is Started Within 180 Days
P I L I I I r r
a h I a. IT
"Appl!canf�on 1,?,rnsppuse, heirs, assign. and
I , I
IT b IT h
A P p I I a I 0 a
N E E
G. ION FEE
I C
N. P E T
EN INSPECT
EN
" n a d 0,
r Cl. d IT d
BLOC' "I nta C �d hify, defend an
S a I. I I IT I I ,
I I I S�
5h is offl.IIo
I IT on, B
I o, E Vr
harrR1::E In. City of E . Srd not"i
IT or m a B In '
a
- ms or dam....
g
MployeeS, and agents from any and all claims or dam a of
m p y .. and -g on, a 'mm
I 'y ".in 'he I -Su-nC
whatever nature. arising directly or Indirectly from the ssuanc
whatever net -re a".m. If I To.
0
of this permit, Issuance of this pe,,,Ml.t Sthofll nnol Cie doiemed to
I I his IT I I ..no. I I . of be do. M - to
p ' I
P S IT
PLAN CHECK DEPOSIT
PLAN H E
d Ce
. an To n , ,I, -rd n-n-e
modify, waive or To u an" r.q. TIT n y ty ordinan
m. It I " W ay. -, r-du - ' ' s c. any -rd(n. rIc.
IT ity's ability to enforrce any o�d(nance
I he I "
I c: C
N T DUE
TOTAL AMOUNT DUE
TOTAL A-.0
I I � any Way
no I I an,
m
nor limit
r
provision. i
provision
are" 0 111 cat I I he he
I hereby acknowledge that I IT . eve road gis appl(cati 00n,;,,hj`d,hy
is correct; and h6omolwq, or. in. I
ar. I:tO I
- ; -
AIEN'T�
A ENT C IN
I APPLICATION APPROVAL
Information given I'll't'itt
d '�IS RE j, '\ " �\'
Is R
authorized agent of the owne algre with city Sfid) - C
u , orz. g I of Is W or .m p Wit I 'Y RE
This application 1. not a permit, until
lelawsr gulBtmgconstru4=In,q.i I ng I I he w.rII
5'. 1 . I at I g .0 at tIo ng or. I G iz.
to
by' a
will be d IT violationfol the Labor
r.0 W be an Ole 'o n� I I he Labor
. I
AU1..FI11S
U
CA" THE
T
5 ned 'DIE"il.d'Ing Off a' or 1.,Ph r
'
I, IS
b.nd C ti
0 P.
a. thereby, no person
in To
Com
C
0 We. on m
Code of the Stat 'on relatl ng to Workmen's pensa-
N D
NOTED
WGX 'E
Dig
p S p.idl.ictind
acknowledged in space provided.
tio IT nsurance A 7.
DATE SIGNED
INSPECTION
DEPARTMENT
SIG�WU E
-
CITY OF
TF TE
S
EDMONDS
CALL FOR
FrELEASED By
ATTENTION
INSPECTION I
IT IS UNLAWFUL TO USE 08 OCCUPY A BUILDING OR STRUCTURE
INSPECTION HAS BEEN MADE AND APPROVAL OR
--
[1 -0220
ORIGINAL - Ffle YELLOW - inspector
UNTIL A FINAL
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
10247
PINK - Owr.er GOLD - AS11.SSO,
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