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20000694.pdfDATE RECEIVL CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS 12,2, /o (' /,,,. m — �AILING ADDRESS 19 o 7ol-I e- ",l CITY ZIP TELEPHONE PERMIT EXPIRES ID JaLL USE PERMIT -2 - �X,6*4 ZONE 5 NUMBER SUITE/(PTL ADDRESS -1 PI -AT NAIADSUBDIVISION NO. L Lo OT N TNO IID NO, LID FEE $ B PUBLIC RIGHT OF WAY PER OFFICIAL ;TF�EOT MAP TIE PA- P ,.E.p FW P.U.1 R.I. R.""d I —I u� P.-I R.q I S E P. .q EXISTING — PROPOSED- REOU)RED DEDICATION— FT W1,10 METER SIZE I LINE SIZE NO- 01 FIXTURES P EV.. PRV FE.U, PED YE S . . . YES 13 NO 0 ADDRESS WNEWCONTRACTOR RESPONSIBLE 'OR EROSION CONlR'uu"' OWNERICONTRACTOR RESPONSIBLE FOR EROSION CON�Lfi�Uum I CITY ZIP JTEIEP"ONE NAME GtNE5RING RE—WEDIDATE E.GtNIEERING REVIEWEDI-ATE m ADDRESS FIRE REVIEWED BY DATE ZIP t TELEPHONE 7 79 VARIANCE OR CU SHORELINE OR ADSI INSPECTION ON STATE LICENSE NUMBER Ea.D POSTED 0 YES m — 6 121? 9,_/11 SERA REVIEW SIGN AHEA HEIGHT EMPT ALLOWED PROPOSED ALLOWED PROPOSED PROPERTY TAX ACCOUNT PAR EL NO. COMPLETE I E Ll :5 j/ EX P NEW RESIDENTIAL, 0 PLUMBING t MECH I CKS ) PROPOSED SETBACKS (FT) LOT COVERAGE AEOUIREO SETSA (Fr. ALLOWED PROPOSED FRONT SIDE REAR FRONT UPSIDE REAR ___. ADDITION COMPL ANCE OR CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED By DATE REMOQIRf_ 0 APARTMENT I SIGN REOD I PROVIDED FENCE 'REIA GRADING CYOS X FT) REMAHKE C] DEMOLISH TANK H GARAGE C] RETAINING WALL RENEWAL CARPORT f (TYP F SE,SUS.ESSO IVITY) EXPEA CHECKEDBY YPE F CO STRUCT .�.UPANA, r ROUP I NUMBER N SER F CRITICAL SPECIAL INSPECTOR AREA '_u__ OF IN AREAS Af REQUIRED 1L.AD YES STORIES NUMBER C] DESCRIBE WORK TO BE DONE REMARKS PECTIONREQ jy /,g cj-, /77 005-f VALUATION FEE PLAN CHECK FEE LOT SLOPE I SOURCE BUILDING PLAN CHECK N2L___-- ESTED DAT�E_ r PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK I . BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL IS DOMAIN (CURDS. SIDEWALKS. DRIVEWAYS . MAROUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. STATE SURCHARGE P R IT APPUCATIoN: A80 DAY E M P I PERMITLIMIT.1 YEAR, ROVIDEDW RK SSTARTEDWITHIN IRDVAYS ENG, REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 001 A F HIS OR HER SPOUSE. HEIRS. ASSIGNSAND SUCCESORS CITY OF NT�."A NO IN ;'A9PLICAN7�0N.BEHALF I FE�S T �NDEMNIFY. DEFEND AND HOLD HARMLESS THE N,NTE IIE. REES T AND AGENTS FROM ANY AND LA SC PING INSPECT NFEE TS OFFICIALS. EMPLOYEES, OFWHATEVER NATURE. ARISING DIREC LYORINDiRECTLY 5 P RMIT SHALL NOT BE PLAN CHECK DEPOSIT 0 ANY ITYORDINANCE DFDINANCE PROVISION,' TOTAL AMOUNT DUE THAT I HAVE READ TKI$APPLtCATION. THAT THE INFORMATION APPLICATION APPROVAL IHERE Y ACKNOWLEDGE GIVEN% CORRECT: AND THAT I AM HE OWNER, OR THE DULY AUTHORIZED AGENT OF P-71 ."I "g— b, lt,. THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL 61 LE11 E RE ATI�N-GYTD FOR INSPECTION ,p- llkwl.d9QdP.ce pro�ided. IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON WORKMEN'SCOMPENSATK) INSURANCE AND RCW 18.21. OF ICIALS1,11EJ DATE SIGNED (425) SIGNATURE (OWNER OR TATE 771-0220 I ELEASEDITY EXT 333 ikTTENTt6N IT IS UNLAWFULTO USE OR OCCUPYA BUILDING OR STRUCTURE UNTI L 771-0221 �YELLOW INSPECTOR INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL- FILE - - GOLD ASSESSOR A FINAL BEEN GRANTED, LED SECTION 109 FAX PINK WNER o CATE OF OCCUPANCY HAS 519. z om m 0 --lo 0 c: -4 E , X M m 10 c �ca 0 n m A V5 0 0 rm ca M 0 z z z 0 1 0 m RECORD OF INSPECTIONS INSPECTOR SETBACKS ..................... FOUNDATION:, Footing ...................... wall .......................... Pier/Porch ................. Retaining Wall ........... Slab 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 Wall Insulation ........... Ceiling Insulation SHEETROCK NAILING SPECIAL INSPECTION FINAL APPROVAL FOR OCCUPANCY .................. DATE APPROVED M 80 C x m 0 -n M M a- 0 0 m C w m 0, z Z, C, IAN occu, 171OLZI F10-5r-) GROU m I = CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ADDRESS D 70 0 ZIM 9 &. C' , 0; ITI ADDRESS CITY ZIP ITE111"ON1 NAME ADDRESS z P ZIP TEL�HO;: 91 � =v.L6 �E=�79 7 _ _tg STATE LICENSE NUMBER EXPIRATION UA4 a 12 )" --9/lo/ C] NEW RESIDENTIAL 0 PLUMBING I NIECH C3 ADDITION C MPLIANCEOR Cl CHANGE OF USE E] SIGN GRADING CIDS X FT) DEMOLISH [3 TANK oGARAGE CARPORT 0 RETAININGWALL RENEWAL ITYP F SE.BUSI ESS OR ! N�S _Q 7U..E��0.1 NUMBER N DWELLING ACIII�TAQAL AS 0 7 STORIES UNITS NITS NUMBER NUMBER DESCRIBE WORK TO BE DONE 1;7 eLi., UU JA_,.fl PERMIT EXPIRES - USE PERMIT ZONE R5 <R NUMBER jos SUITE/11T, a.Z� _ ADDRESS 1c) PLAY NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIALSTREET MAP TE .. �`d I,= EXISTING — PROPOSED — I _ 'T APQUIRED DEDICATION FT __�_ETgR SIZE LINE 51ZE NO. OF FIXTURES PFV REQUIRED I Y S" ES NO REMARKS ENGINEERING 51RE REVIEWEDBY DATE VARIANCE OR CU SHORELINE OR ADB. INSPECTIO REDID BOND POSTED E3YES ONO SEPA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALL ED EMP I I _PROlOSEO LOTC VERAGE REGUIREOSETBACKS(FT) �ROPOSED SETBACKS (FlI ALLOW50 PROPOSED FRONT SIDE REAR FRONT URSIDE REAR PARKING LOT AREA INNING REVIEWED By D E RED D I PROVID D]. CHECKED 6 CTOR JAREA S'ECIAL'� SPE REQUIRED E3 YES IREMARKS ........ ... VALUATION FEE PLAN CHECK FEE L BUILDING PLAN CHECK [V—E. LAI PtumplING MEC HANICAL THIS PERMIT AUYHORI�ES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL DOMAIN (CURBS. SIDEWALKS. DRIVE S, MARQUEES, ETC.) WILL REQUIRE DOMAIN "URB' S WAY "DEW' SEPARATE PER STATE SURCHARGE P IT APPLICATION: 180 DAYS P ::: ROVIDED WORK IS STARTED WITHIN 180 DAYS I ER M AR' I ' -A ERMIT LIMIT.- I YE P ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION ..FF 0 0 ON BEHALF OF HIS OR HER SPOUSE, HEIRS ASSIGNS AND SUCCESDRS 'F oFNS �APPLICANT. IN D HARMLESS THE CITY OF INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOL T LANDSC PING D oNUS.WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANYAND M I ON IT' EDMo U A�A LCLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY L MAGESo INSPECTI N FEE REC I FA M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT,EHALL NOT BE o OF T� PLAN CHECK DEPOSIT Ty E. . MODIFY ANY REQUIREMENT OF ANY C ORDINA CE DEEMED To MODIFY, WAIVE OR REDUCE AVE" lHOVISI C) C7, 0 NOR LIMIT INANYWAYTHECITY TO ENFORCE ANY ORDINANCE THE N R I, IT IN Y W Y '$ABILITY TOTAL AMOUNT DUE L PPL ATION THAT THE 'NloHM ATION I HEREBY ACKNOW EDGE THAT I HAVE READ TH15 A APPLICATION APPROVAE GIVEN IS CORRECT AND THAT I A. THE OWNER . CRT ICE DULY AUTH.F'�E C AGENT F W �lo t,' T"' C THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL pul, — F — p.,d. TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED OF WASHINGTON RELATING TO FOR INSPECTION ... ipi I, ,I,..wIld9ld,, p.co pl—d.d. IN VIOLATION OF THE LABOR CODE GF THE STATE WORKMEN'S COMPENSATION INSURANCE AND RCW 16.21 OF ICIALS SIGN RE DATE SIGNATURE (OWNER OR AGENT) (425) 1 /"-� 1 771-0220 ELEAQED BY g�"' EXT 333 ATTENTt6N IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 HAS BEEN MADE AND APPROVAL OR A CERTIFI� ORIGINAL -FILE - YELLOW- INSPEC70R A FINAL INSPECTION CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER - GOLD - ASSESSOR z 9 0 m ma -4 0 0 0 c: rn M Z 'D -I c 2 > -4 co o -n n rn T 0 0 o C ca m co mo Z� X z co z In