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20000667.pdfCITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION -Sk -'s ITY ZIP ITI EPIONE A J�j r'A A � D, t4 ? -7 -2 � AODRISS [CITY ZIP ITELEPHONE NAME m ADDRESS 0 CITY ZIP TELEPHONE STATE LICENSE NUMBER PROPERTY TAX ACCOUNT PARCEL NO. 00-7 00 NEW RESIDENTIAL 111.11,11ING I VEC" 0 rADDITION 0 C3 COMMERCIAL COMPLIANCE OR 'HANGEOFUSE REMODEL APARTMENT SIGN REPAIR FENCE 0 GRADING CYDs E3 X FT) C] DEMOLISH 0 TANK OTHER c GARAGE T t CARPORT RETAMINIRNYG WALL. 0 RENEWAL ROD E Is (I YPE OF USE. B TIVITY) EXPLAIN: NUMBER NUMBER F __TEAZE R'T'CAL 1pt-7 OF STORIES G DWELLING I. DESCRIBE WORK TO BE DONE [PERMIT EXPIRES USE PERMIT <� '.N�aS __ NUMBER JOB SUITEIAPTA AQDRESSC� U-) I z FLAT NAMEISUBDIVISION NO. LOT No, LID NO, I LID FEE 5 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 'E'cp Ap "I Fall, Ild, 0 EXISTING — PROPOSED - 0 R".a 13 REQUIRED DEDICATION— FT 0 PRV REOUIRED [r!!:[!= YES 0 No 0 REMARKS OWNEMCONTRACTOR RESPONSIBLE FOR EROSION CONTR FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADB# INSPEC iON REQ'O I BON POSTED OYES ONO SERA REVIEW SIGN AREA HEIGHT ALLOWED PROPOSED ALLOWED PROPOSED LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SCTBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT URSOE HEAR p .. �,G L;77�� FEWEV0E. BY DATE CHECKEDBY TYPEOF Q�blliuullul Pv.-Io PECIAL INSPECTOR AREA PANT REQUIRED 0 YES LOAD REMARKS , --cat imqpFrTIOMS PER UBC 1081FINAL INSPECTION REO'Dill. VALUATION FEE P AN CHECK FEE GLtZING E I UILDING PLAN CHECK NO: I umsINQ MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THISPERMITCOV ASWORKTO BE ..... PRIVATE PROPERTY ON� ANY CONSTRUCTION ON THE PUBLIC L '�UR.S. MAROUEES, ETC.) WILL REQUIRE 2 SIDEWALKS, DRIVEWAYS. SEPARATE PERMISSION. GRADINGIFILL STATE SURCHARGE 2 PERM T APPLICATION: III0 DAYS PERMIT LIMIT'. I YEAR . PIRIOVIDEO WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION ENG, REVIEW FEES �APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESOVIS N INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS — L'.YYA-1 EDMONDS. WASHINGTON, ITSOFFICIALS. EMPLOYEES, AND AGENTS FROM AN NO ALL CLAIMS FOR DAMAGE, OF WHATEVER NATURE, ArISING DIRECTLY OR INDIRECTLY FROM THESSLIANCE OF .IS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE R REDUCE ANY REOUMEMENT Or ANY CITY ORDINANCE DEEMED TO MODIFY. WAIVE 0 'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,' NOR LIMIT IN ANY WAY THE CITY LANDSCAPING INSPECTION FEE PLAN CHECK DEPOSIT T07AL AMOUNT DUE EIPT RECEIPT I HEREBY ACKNOWLEDGE THAT I HAVE READ THI S APPLICATION, THAT THE I NIORmATION GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE 0 NER. I AGREE TO COMP T 5 REGULATING G.NsTRu LY WITH CITY AND STA E LAW TION. W THEREBY. No P L BE E-PLoE% o ER$oN wIL IN VI ANDtIN D ING THE WORK AUTHORIZED E STATE OF WASHINGTON RELATING To OLAT ON OF THE LABOR CODE OF TH WORKMEN'S COMPENSfIOl INSURANCE AND RCW 11,11, LL �41 APPLICATION APPROVAL CALL B." n., a ann, iI .,glld by Ih, d1l.rI "'. I "I hl' Dlply� and ran, .11 p1d. and .0n.—dipal In ap.. pl.vldad. Ilkn FOR INSPECTION 0 FICIA S SIGNAT DATE (425) 771-0220 R EASEDBY DATE ATTENTION - EXT1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221 ORIGINAL RLE YELLOW �NSPECTQR A FINAL INSPECTION CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK OWNER GOLD ASSESSOR 5M$ z r9 =i ui m M 0 0 0 3: M M Z CA 0 "n -n m ni 0, 0 c M CA no .1 M 0 X z cill z 9 0 IT! RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall.......................... Pier/Porch ................. Retaining Wall .......... Slab Insulation .......... PLUMBING: Underground ............. Hough -in ........... Commercial Final HEATING: Gas Test .................... Gas Piping ................. Equipment ................. commercial Final EXTERIOR SHEATHING NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING_ INSULATION ................... Floor Insulation Wall Insulation ........... Calling Insulation SHEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. Z' �.5 rn C Ma 0 -40 0 C. -4 C IT o -n .n L, M T C, co 0 0 a 113110 Z ki ca z M CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION I ADDRESS AIUN 0 �� I ?_ 5- � \ CITY ZIP El _7 _)ij -1 1 _/_ " L) IT LEPHONE I ADDRESS CITY ZIP";, ITELIPHONIE NAMI(_ .) U )(\4�'Jr--�-Q bf ADDRESS,� _j) _ _(?),\ CS. e �\ CITY ZIP TELEPHONE STATE LICIN I NUMBER EXPIRATION PROPERTY TAX ACCOUNT PARCEL NO. 6Z41T-0C)g-M-7- CDO-Dl 0 NEW A -SIDNTAL PLUMBING/MECH ADDITION IE.,_ o COMPLIANO OR C] --M CHANGE OF USE t�OA'PAATNIENT C] REMODEL 0 SIGN FENCE REPAIR GRADING CYOS 1:1 1 FT) DEMOLISH 0 TANK 0 OTHER GARAGE RETAININIDWALL RENEWAL CARPORTf ROCKER (TYPE OF USE. BUSINESS 08 ACTIVITY) EXPLA7N. I NUMBER lUllEl IF RITICAL n re DWELL NO AREAS _.T. I I NUMBER \,�DL_j %14 DESCRIBE WORK 70 BE DONE % A: t t �-- - I PERMIT EXPIRES *,tL 4-1--+—L SE PERMIT NUMBER 2COG07— SUITEJAPT# DOFIESSC I, 7LAT NAMEISUBIXVISION NO. LOT NO. LID No. LID FEE S ... Ppl... R� 1—o A�- I PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED S_tUl.PRR.q'd 1.ot � Rol... 0 SWI-W R.quIld 0 REQUIRE D DEDICATION— ET PRV A UIRED YES 0 NO E3 R MARKS P—PEIF EROSION CONTROIJORAINAGE ENGINEERING REVIEWIDIR� z 0 _.. DATE FIRE REVIEWED BY =1 0 rn VARIANCE OR CU SHORELINE OR ADB# INSPEC ION REO.Q I BOND POSTED 0 YES E3 NO M ___�EPA REVIEW COMPLETE EXEMPT ALLOWED SIGN AREA PROPOSED HEIGHT ALLOWED PROPOSED 1 I C= EXF m 0 -4 . �! 0 LOT COVERAGE REQUIRED ALLOWED PROPOSED FRONT S ACKS SE1 DTO ("T E REAR PROPOSED SETBACKS (Fr.) FRONT UPSIDE REAR 10 LOTAREA PLANNING REVIEWED Ely PEGG PROVIDED I 7-EMARKS I, t 0 _n n MITI C3 aj It" ILL CHECKEDBY TYPEOFC NSTRUCTON 0 PA C27-1 GCCUuP W\) Q�) 0 0 S PECIAL INSPECTOR REA Oc T LOAD REQUIRED YES 0 RE-FIKS PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REO' -7c, CA c� z z VALUATION FEE PLAN CHECK FEE 0 m GL�Z LOT SLOPE % BUILDING ZCE PLAN CHECK NO: IVESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. STATE SURCHAR 2 G_E 'T CH S�l _ "MITAPPLICAR N: ISO DAYS P K IS E PERMIT LIMIT. I YEAPRE ROVRDEDWOO STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK O� PINK PERMIT FOR MORE INFORMATION ;APPLICANT ON BEHALF OF HIS OR HER SPOUSE. HCIAS. ASSIGNS AND SUCCESORS i N WERE T, AGREES TO:ND NIFY, DEFEND AND HOLD HARMLESS THE CITY OF I EOM ) LANDSCAPING ANYAND OB.SWASHINGTON. ONION TS FFICIALS. EMPLOYEES. AND AGENTS FROM A C E DIRECTLYORIN I E TLY S PISTON OFIVIIATEVER NATUR"Ol �F.. INSPECTION FEE RECEIPT M DAMAGE 5 FOR NCE - " -19 PERM T -ALL NOT BE . .IT. ES A E THE '-SUA OF I IS PE ORDINANCE ILAN CHECK DEPOSIT UCE Y AE.ENT.F ANYCITY "Y Ft ED AN REDD, ISION.* I AN Y THE CITY S ABILITY TO ENFORCE A DINANCE PROVISION.* ..A LIMIT N 0 Y W�_AIVE 0 NY.A TOTAL AMOUNT DUE AEC IPT IHERE Y ACKNOWLEDGE THAT I HAVE REA. THIS APPLICATION; THAT THE INF AVIATION a 0 AGENT OF 'e� C 1 '!,0 jl�c_ APPLIUAI [Ulm A I VAL I I by GIVEN 15 CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED TRUC THE OWNER. I AGREE TO COMPLY NTH CITY AND STATE LAWS REGULATING CONS - CA L ' I ,I s,gned tho og 011,ci,l o, N,mor spoly ..d Fool — p,,d. d Bu.j Th', PPIklbon` 13 : IN DOIN THE WORK AD HORIZED THEREBY. NO PERSON WILL BE EMPLOYED T,ION; AND 0 ABOR C DE OF T HE STATE OF WASHINGTON RELATING TO FOR INS TION ....p, I. o.—Iodg.d M p.. provided. N VIOLATION OF THE L WORKMEN'S COMPENStTION INSURANCE AND RCW 18.27. DATE �FFJCIALS SIGNATYAE,., r.EN (425) 771-0220 M% RAEASED By DATE' EXT1333 ATTENTION IT IS UNLAWFUL TO USE OR 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 - ASSESSOR 5196