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20000676.pdfo c 04 - FPERMIT EXPIRES U USE PERMIT Zo()(;Lb CITY OF EDMONDS ZO N E ZONE\�_S " — S --t NUMBER 0 ' N CONSTRUCTION PERMIT APPLICATION 6 JOB 'AD 0 R E 'S ADDRESS 0 SUITEJAPT# lt� zm r cl TIL OW7 ou"=72,., VI PLAT NAME)SUBDIVISION NO. LOT NO, LID NO. ,�AM2��Dl LID FEE S MAILING ADDRESS E.1,1.P, I— I I PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP P �11.­­, - ­­0 EXISTING PROPOSED =' 'A t CITY ZIP TELEPHONE 7C REQUIRED DEDICATION FT _­ LINE SIZE M SIZE NO. OF FIXTURES PRV REOUtRED NAME I YEsO No 0 ADDRESS REMARKS --r—TRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE CITY ........... NAME ENGINEERING R5VISWED/DATE ADDRESS A FIRE REVIEWED By DATE .1 ly ZIP- TELEPHONE VARIANCE OR CU SHORELINE OR ADO INSPE TION I BOND REO'D STATE LICENSE NUMBER IPOSTED 0 YE5 E3 NO W SIG AREA HEIGHT SERA REV" PROPOSED CO."ETE EXEMPT ALLOWED PROPOSED ALLOWED PROPERTY TAX ACCOUNT PAR EL NO, 1 3-7/1 CCDC) OcD f -00 1 LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT) FRONT SIDE REAR FRONT UPSIDE REAR 0 NEW GR RESIDENTIAL C3 PLUMBING I MECH ALLOWED PROPOSED 19 ADDITION C] COMMERCIAL C MPLIANCE OR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY U.I 1 [3 REMODEL APARTMENT SIGN REQ'D i PROVIDED (3 REPAIR GRADING CYDS FENCE x FT) X EM KS C3 DEMOLISH 0 TANK 0 OTHER MqAR;A. CRT WALL. RETAIN EWAL 0 FOC�EE RE. 0 p (TYP E. BUSINESS OR ACTIV��XPLAV CHECKEDBY TYPEOCO�VT LOTION C4 0', _7 G.. NUMBER NUw �BlROF Dw LL N. CRITICAL AREAS Ll pECIAL INSPECTOR AREA �j> F��C�UPANT OF C STO IES R NUMBER t� OU RE 19ED [] YES C3ar DESCA t�YO� _CE M A/kJ=L.A= a- REMARKS PROGRESS INSPECTIONS P R UBC 1081FINAL INSPECTION REO'l ci P-C i: -cc I I �,t p HEAT SOURCE GLAZING I LOT SLOPE % PLAN CHECK NO: �VESTIDDATI T.'S.PERMIT AUTHORIZES ONLY THE WORK NOTED. '-IS PERMIT COVERS WORK TO !Z E DONE ON P,,,V,,T PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS ROVIDED WORK IS STA TED PERMIT LIMIT. I YEAR ' P ITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS IN NTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF OFFICI LS, EMPLOYEES. AND AGENTS FRO. ANY AND 2 EDMONDLWA""To' T' WHATEA . ALLCI-Al- F-R-A-A-E�GF VER NATURE. ARISING .1PECILY-R INGIFE�Tl x FROMTHEISSUANC 0 THISPERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE OF C ORDINA E DEEMEDTO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT ANY IT' NO NOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' APPL CATION THAT THE INFORMATION S C I HEREBY ACKNOWLEDGE THAT: HAM"THREFOOWTHER, OR THE DULY AUTHORIZED AGENT OF GIVEN IS CORRECT. AND THAT G CONSTRUC- THEOWNER. I AGREE TO COMPLY V41TH CITY ANDSTATE LAWS REGUI-ATIN TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR COD E OF THE STATE Or WASHINGTON E LATiNG TO WORKMEN'S COMPENSATION INSURANCE AND ROW 18.27� DATE SIGIEG -I= . 17, , VALUATION FEE LAN CHECK FEE BUILDING PLUMBING MECHANICAL GRADINGIFILL STATE SURCHARGE ENG. REVIEW FEES IING, INSPECTION FEE LANDSCAPING INSPECTION FEE PLAN CHECK DEPOSIT TOTAL AMOUNT DUE REJ lPb APPLICATION APPROVAL CALL FOR INSPECTION Ilk-11dol— 1P.-O Pr0Vld0d F ICIALSSIGNA URE GAT (425) 771-0220 i EASED By o 00 lhl ATTENTION r—A It 00.3 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 ORIGINAL FILE YELLOW INSPECTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR S198 C) m 0 m m 0 c: m 'n 0 -n n m m 0 o F. r c) 9 cn M 0 Z >z TA ca z m VALUATION FEE LAN CHECK FEE BUILDING PLUMBING MECHANICAL GRADINGIFILL STATE SURCHARGE ENG. REVIEW FEES IING, INSPECTION FEE LANDSCAPING INSPECTION FEE PLAN CHECK DEPOSIT TOTAL AMOUNT DUE REJ lPb APPLICATION APPROVAL CALL FOR INSPECTION Ilk-11dol— 1P.-O Pr0Vld0d F ICIALSSIGNA URE GAT (425) 771-0220 i EASED By o 00 lhl ATTENTION r—A It 00.3 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 ORIGINAL FILE YELLOW INSPECTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR S198 C) m 0 m m 0 c: m 'n 0 -n n m m 0 o F. r c) 9 cn M 0 Z >z TA ca z m 00 lhl ATTENTION r—A It 00.3 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 ORIGINAL FILE YELLOW INSPECTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR S198 C) m 0 m m 0 c: m 'n 0 -n n m m 0 o F. r c) 9 cn M 0 Z >z TA ca z m FINAL PROJECT APPROVAL FORM TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE. - ENGINEERING DIVISION DATE z —Es— PLANNING DIVISION DAT PROJECT ai --i am moo PL C M0 0 SITEADDRESS. 0 q16510 INSPECTED 41eAb I C X M Mz PERMIT ____ADB#___---PATE 0-4 DESCRIPTION OF WORK TO BE INSPECTED &VvAfytg� — z W A field inspection was conducted to determine compliance with approved plans. Final approval denotes that 0 -n n there are no objections from the above signed Department to the granting of: m M Final approval of the described work a U5 0 0 C MU) FINAL PROJECT APPROVAL C co M 0 Z GRANT PROJECT APPROVAL WITH CONDITIONS NOTED > z 99 z 2 FAILED FINAL INSPECTION - OUTSTANDING ISSUES APR 2 0 M CITY OF [Sorf,�C' 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL ocaprvi.doc.l:temp:bldg:fonns6/98 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Well ............. ............ z 0 Pier/Porch ................. M Retaining Wall ........... -4 -n Slab insulation .......... PLUMBING: 0 rn C in 0 Underground ............. -40, Rough -in ................... IR IT! Commercial Final HEATING: > Gas Test .................... 0 _k Gas Piping ................. "I k Equipment .............. IM, M Commercial Final o Fn EXTERIOR SHEATHING NAILING.......................... In't 0: FRAMING........................ 'FIRST FLOOR FRAMING INSULATION ................... Z� Floor Insulation Wall Insulation ........... Z, Ceiling Insulation SHEETROCK NAILING M, Ll SPECIAL INSPECTION MISCELLANEOUS .......... APPROVAL FOR _y)_S FINAL OCCUPANCY .................. dft Ak PERMIT EXPIRES USE 'Q ZONE C_ Prillmll 14Uk)b 1/0 CITY OF EDMONDS NUMBER' CONSTRUCTION PERMIT APPLICATION JOB ADDRESS SWTVAPT. OW XAM�� OF BUS!NjES2S7,, PI -AT NAMESUBDIVISION NO. LOT NO. LID NO. LID EES MAILING ADDRESS PUBLIC RiGHT OF WAY PER OFFICIAL STREET MAP 1 AElCP'Ap .P. EXI G — PROPOSED- SM.— R­­ 0 TELEPHONE -7 70 97 7) RE RED DEDICATION FT — ETER SIZE LINES11E NO. OF FIXTURES PRV REOUIRED NAME i 8S13 NO 0 z ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 71�n CITY ZIP ITELE'"I'l ENGINEERING .1 ADDRESS I- I / i A FIRE REViEWEDBY DATE 'I CITY Zip TELEPHONE 0 VARIANCE OR CU '. INYIE'ECTION DDI STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY ::ADBI RE � PBON. E '2 NO DST C SERA REVIEW N OMPLETE EXEMPT ALLOWED I PROPOSED ALLOW HE—IGHT ED I PROPOSED PROPERTY TAX ACCOUNT PAR EL NO. :9 7 e!) 0 L--> 0 C�) If EXP N 40T COVERAGE REQUIRED SETBACKS JFT.) SIDE REAR PROPOSED SETBACK$ (Fr.) FRONT LIFISIOE REAR 0 NEW PLUMBING I MECH PROP FRONT ALLOWED OSED 0 ADDITION COMPUANC OR cl CHANGE OF USE ED BY DATE 0 REMODEL SIGN PARKING REO'D I PROVIDE D REPAIR C] GRADING CYDS FENCE El X FT) REMARKS 0 DE40LISH 0 TANK o OTHER AG > GET Mgpl iT RETA�INIRNYG WALL FOG 0 RENEWAL (ITY ' E. BUSINSSS 0.:11 ll;L� C,,,,CKED9;p,rqCONT UCTION -7 GRou NUMBER NUMBER OF GE ;ITICAL ;EG7 1 REA L OCCUPANT OF DWELLING 11 NITS AREAS A, MBE NU R EOU RE R 1 0 C] YES LOAD 16c, STORIES DESCRIBE WORK TO BE I I I -- IZ IN I ,I1 IAA� - I If\ J�E 5,' - REMARKS_ -0 E 081FINAL INSPECT N R LAJ OR CODE VALUATION FEE PLAN CHECK FEE G �aZ IN G —%I. LOT SLOPE % BUILDING Plew HEAT SOURCE I kSTEO PLUM51NG DATE PLAN CHECK NO: MECHANICAL — - N T4EWORKNOTED. T IS PERMIT COVERS WORK TO THIS P ORMSO Y ERMIT AUTM I ION ON THE LIC R HLY A Y NSHFUCT _ P B BE DONE ON PRIVATE P OL PCRTYO - " GO C WILLREOUUIRE GRADINGIFILL GE W YS GLEES ET tCURBS� SID S DRIVE A MAR DOMAIN CU I EWALK ' :I SEPARATE PERMISSION. PERMIT APPLICATION: 18DUAYS AR IS ITHIN 180 DAYS PERMIT LIMIT. I YE 'PROVIDEDW,ORK STARTEDW ENG. REVIEW FEES SEE BACK OF PINKPERM FOR MORE INFORMATION ENG, INSPECTION FEE ;AP LICANT. ON BEHALF OF HIS OR,,HYER Sp.oUSE HEI.R&.ASS�GNS AND SUCCES.RS P EF :N HARMLESS THE CITY OF LANDSCAPING GEM , N INTERE.IWT AGREIETOT.O "S GE ASH'N :1 OFFICIALS' E"pULAOE,.EES,�ANGOD�IGECNTTLSYFOROM AN INSPECTION FEE RYAND E.Mo . A LCLAIMSFOFIDAMAGESOFWHATEVER NAT A. IN RE RINDI ECTLY ' BE RECIRIll I FROM THE ISSUA NCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT PLAN CHECK DEPOSIT 9 DEEMED Fy. WAIVE OR RE CEANY PEOUISEMENTOF ANY CITY ORDINANCE OINMODIWAY AULITY PROVISO- Ipb 0 NOR UNIT THE CITY'S TO ENIOECE ANY ORDINANCE m RE TOTAL AMOUNT DUE APPLICATION APPROVAL HAVE REA THIS APPLICATION; THAT THE INFORMATION I HEREBY ACKNOWLEDGE THAT I ,E IER. OR THE DULY AUTHORIZED AGENT OF T AND T-ATIA" TH' - Thl. IPP" -t'O- 11 �-1 - P-1 GIVE' IS CORRC - STATE LAWS ,.UTNC CONS T E OWNER. I AGREE TO COMPLY WITH CITY AND TRUC CALL D Bl,lldllg Oj(,­i ., Nvhor apuI`y: ��,J'F­ .1. TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILt BE EMPLOY ED OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION -wi,, 110111,dg,d,� p.,o pf-dod, IN VIOLATION OF THE LAB DA E WORKMEN'S COMPENSATION INSURANCE AND RCW 1 B.27. F lClALS SIGNA URE r.I.NAT.FE IOWNE. OR A.IRNTI (425) 7 -0220 EASED BY E 71 EXT1333 ATTENTION IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 ORIGINAL FILE YELLOW INSPECTOR A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- PINK -OWNER GOLD ASSESSOR CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 FAX SIBS z 0 0 0 m c m 820 m mz 10 ::! :"., c > z 0 -n n M M 0 0 o C z z ch z IT!