20000744.pdf-1 DATE
I =
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
'2�;Zj" 6,11eft 60AI
M NG ADDRESS
AIU
CITY ZIP TELEPHONE
,rNmOS ftA 15762Z 42-6--7Ar—el
PERMIT EXPIRES 4L8/ _0j
USE PERMIT -2b0714-�
ZONE NUMBER
11113 SUITEJAPT,
ADDRESS r_St4A&JW5f
PI -AT NAMEISUBDIVI SION NO, LOT
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
lEllP A,,,-,'
P
EXISTING — PROPOSED-
, 81
b.. F.q.".d
REQUIRED DEDICATION— FT
0
J-191—d
lE E
.E R S'Z �T
INE IIE
L E
0. OF FIXTURES
FFV F U, B
REQUIRED
Y y S . . .
ES 0 NO E)
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
NAME
&0 namyo'w rx�'n El INEEPING REVIEWEDIDATE
ADDRll?e.
X PI HE REVIEWED By DATE
�R ;? �H'N E
CITY ZIP TELEPHONE
FATE CICE�7SE NUMBER
EXPIRATION
DATE ECKEO BY
YES NO
co
c
A F�::
—SIGN AREA
HEIGHT
,fZ1_
_-z-eev
COMPLETE: EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
R2TAlr�ACCOUNTI
L NO.
tEXP
,
IS
zf�)L
_�EOUIPED
LOT COV E AGE SETBACKS (FT)
PROPOSED SETBACKS (FT.)
NEW
CKRESIDENTIAL
0 PLUMBING I MECH
ALLOWED PROPOSED FRONT SIDE REAR
FRONT UPSIDE REAR
0 ADDITION
COMMERCIAL
C VPUAN E OR
0 OF USE
1.
CHANGE
PARKING LOT AREA PLANNING REVi— by DATE 2
0 REMODEL ...
0 APARTMENT
C] SIGN
REDO I PROVIDED
I
0 REPAIR
GRADING OYDS
FENCE
X FT)
0 X IT)
REMARKS
REMARKS
DEMOLISH
TANK,
[3
ciGARAGE
CARPORT
RETAINIRNYG WALL
ROCK
0 RENEWAL
CHECKEDBY TYpJOFCONSTFUCTION
f
J.CRC.
NUMBER
NUM81"OF
'IT CAL
IT,
'A.EA.
SPECIAL INSPECTOR AREA
OF
DWELLING
S
B
.
REQUIRED E] YES
lCr
LOAD
STOP ES
L
UNITS
NUM
V BER
DESCRIBE WORK TO BE DONE
REMARKS
PER- uBC 1081FINAL
INSPECTION REO'015
&AIV S96ID—IF
VALUATION FEE
-
PLAN CHECK FEE
SOURCE GI-AZIN 1 % LOT SLOPE %
�EAT G
BUILDING
-C NO
PLAN CHECK NO:
PL A N C H
PLUMBING
-
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS NX IU
TH P ER M IT ALT IZES ON Ly T. B I
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GO o P.'V T. P -PE-TY
E N N A
GRADINGIFILL
DOMAIN (CURBS. SIDEWALKS, DRIVE S. MARQUEES, ETC.) WILL REQUIRE
ALKS - ". WAY
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 1100AYS
M
PERMIT LIMIT'. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG� REVIEW FEES
SEE BACK OF PINK PERMIT FDR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE HEIRS. ASSIGNS AND SUCCESOFS
EBB THE CITY OF
;APPLICANT,
IF'
N INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARML
AND AGENTS FROM ANYAND
LANDS APING
ION FEE
ITS OFFICIALS. EMPLOYEES.
E T o IC
E EDMONDS. WASHINGTON
ARISING DIRECTLYOR INDIRECTLY
INSPEC
ALL CLAIMS FOR DAMAGE. OFINHATEVER NATURE,
E�
01 THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
.......
H, S PERMIT. ISSUANCE
o M ESSU C , I EF
FROM THE ISSUANCE OF TH A REDUCE ANY PEOUIREMENT OF
EENIE TO MODIFY W V ANY CITY ORDINANCE
E
DEEMEDTO MODIFY. WAIVED
1 NOR LIMIT IN ANY AY THE C'TY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION
N OR LIMIT IN ANY WAY THE CITY
.7
TOTAL AMOUNT DUE
RECE
I I AlPT.CEATION THAT I NIO mAT'ON
I I I H '
APPLICATION APPROVAL
I HEREB ACKNOWLEDGE THAT I HAVTEFEADWT RE
ly CID IHE NER OF, BUL Y AUTRo ZED AGENT OF
S FRECT AND THAT' A. ' _N
ull" �11 by F"
GIVEN
THE OW ' AGREE 10 'O-PLY W CITY � TATE "'ATING E-NsTFU
ER 'TH 'Aw"E' 'L.YE%
CALL
dl� 11 hWhG' DOWY ld F1.1 — P. d.
"'c
I� DOING THE WORK AUTHORIZED T j Y
TION, AN HER B No PERSON WILL BE EM o
RELATING T
FOR NSPECTION N,... P—b-_
E ST .
IN VIOLATION OF THE LABOR CODE OF TH ATE F WASHINGTON
DATE
WORKMEN$ C.MP ENSATION INSURANCE AND RCW 18 21.
NED
(425)
0 ICIALS SIGNAT
1 11 1
BIG ER f� E
k,
771-0220
RE ASEDBY DATE
EXT 333
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
APPROVAL OR A CERTIFI-
ORIGINAL FILE YELLOW INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK � OWNER GOLD - ASSESSOR
519.
z
9 -1
0
c m
mo
-1 0
0 0
m m
z
o In
n
m M
055
o Fn
c (1)
;u
z
z
FINAL PROJECT APPRON LFORM
TO:-
-DATE:
NIEMO TO: PERmrr COORDINATOR, BUILDING DIVISION
.FROM: _FIRE DEPARTNENT DATE -(-
ENGINEERING DIVISION DATE —
PLANNING DIVISION D E
PROJECT-J!�'� U S 7—
SITE ADDRESS_
q—, de) c)
PERMIT #
_2�06�.ADB#_----J)ATE INSPECTED—L
DESCRIPTION OF WORK TO BE INSPECTEDLS�/ p1jA-p,
A field inspection was conducted to determine compliance with approved plans. Final approval, denotes that
there are no objections from the above signed Department to the granting of:
yinal approval of the described work
Bonds associated with the project may be released
Y— GRANT FINAL PROJECT APPROVAL
__GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
_RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvl.doc.l:temp.,bidg:fonns6/98
z
9
?i
M
C M
M 0
0
80
C
M
M Z
z
0 -n
rn M
0
0
C: rn
M 0
Z
M
--I
M
z
C0
z
0
:j
0
M
RECORD OF INSPECTIONS
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall insulation ...........
ceiling insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
Zoo-7qq
VV
Z�
c M (J�
m 0
0
al,
m
10
c:
>
m m
a F) ! i,
0
0
c
M
Z
z
F,
z
0 i
M
DATE 711) �)
PER?�IT EXPIRES
PERMIT
CITY OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION 'AOBRESS SUITE/APT#
PLAT NAMEISUBDIVISION NO. I LOT NO. LID NO.
ick S"/,/ LIDFEES
...I IN. ADDRESS TIESC A. -
PUBLIC RIGHTOP WAYPER OFFICIALSTREET MAP -Il R.1.1-
M,Ulftqd I
TEISP.�NE EXISTING - PROPOSED q,,,,,
; Cvl;�471 REQUIBEDDEDiCA11019- FT - Jllw�12.d
METER SIZE I LINE SIZE NO. OF FIXTURES P V REQUIRED
ES 0 NO 0
REMARKS
F.11-TRACT.Ft RESPONSIBLE FOR EROSION CONTF...RAINA.E
—74
CITY
NAME /5 /co 'fa/y
44o' _.r/uc.
E, MESSING REVIEWCD/DATE
ADDRIS;4,. 66'x IRRif
DATE
FIRE REVIEW5DSY
CITY ZIP
TELEPHONE
z
9.?103
'e4ve 17—
OR CU SHORELINE OR ADBN
INSR�E'CTION
D
140�NED
.5F,41r1f
A IUN
STATE LICENSE NUMBER XPIKIld�;A
D By
VARIANCE
D
0 YES ONO
m
co c
SEPA REVIEW SIGN AREA
HEIGHT
PROPOSED
PR4p&AlCOUNT
COMPLETE EXEMPT ALLOWED PROPOSED
ALLOWED
tops"
no
EXP
x
0
LOT COVERAGE REQUIRED SETBACK$ (M.
PROPOSED SET ACKS(FT)
FRONT'.Lf HEIDE REAR
m
c
NEW
C] PLUMB NO I M
CK RESIDENTIAL CH
ALLOWED PROPOSED FRONT SIDE REAR
.
ma
0
ADDITION
E3 COMPLANCE R
0 COMMERCIAL CHANGE OF USE
PARKING
LOT AREA
PLANNING REVII-L .1 DATE
0
c
C] REMODEL
0 APARTMENT E] SIGN
RE D I PROVIDED
I
m m
REPAIR
GRADING CYOS E3 FENCE
IT)
REMARK.
z
lco j
DEMOLISH 0 TANK o OTHER
ciGARAGE C3 RETAKI NNO WALL RENEWAL
ca
CARPORT ROD ER
(TYPE OF�USE, BUSINESS OR ACTIVITbYEXPLAIN:
Aj Fo �AaAl ZIJ6�
CHECK ED BY
ITY
Ir PAr
G P
ROU
0 -n
NUMBER
NUMBER OF
C1111111-
SPEC AL I�il!ECTOR
'A
UL.
m rn
OF
DW ING
ELL
AREAS R
NUMBE
E
REQUIRED YES
0
JAIEA
D
STORIES
U
DESCRIBE WORK TO BE DONE
R EVAN
PER UBC 108IFINAL INSPECTION REQ'D gq�
0
cz m
I .
PROGRESS INSPECTIONS
K cl)
m 0
a j�wf
X
4 P;= Inf hlF AFF1v7
-4
171'rl t-Alo
P
Al
HEAT SOURCE GLAZING %
LOT SLO E I
PLAN CHECK NO:
IVESTEO DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
0 E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
a 180 DAYS
PEPMUT APPLICATION: -DAYS
PERMIT LIMIT: I YEAR 'PROV'OEDWOOK IS STARTED WITHIN ISD
M
SEE BACK OF PINK PERMIT FOR ORE INFORMATION
F 0 F HI S OR H E R S IOU BE. H El A S. A BE 10 N S AN D SUCCESORS
;NP FUERAENST,0��GR SH4L CITY
T R ES To INDEMNIFY. DEFEND AND HOLD HARMLESS THE
AGENTS FROM ANYAND
EDMONDS. WASHING TON TSO, LS EMPLOYEES, AND
I CTLY OR INDIRECTLY
ARISING D RECTLY OR INDIRECTLY
N
A pOAMAGEjl0FWHFlT`ElAER' ATURE
ILL CLAIMS FO C
PERMIT. ISSUAN EOFT"IS PERMIT SHALL NOT BE
x FROM THE ISSUANCE OF THIS
DEEMED To MODIFY.WAIVEOR ABOUCEANY REQUIREMENTOF ANY CITY ORDINANCE
,
0 NOR LIMIT IN ANYWAYTHECITY'S ABILITYTO ENFORCE ANYORDINANCE PROVISION
I HEREBY ACKNOWLEDGE THAT I HAVT READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM HE -W NER. OR THE DULY AIJTHORIZEOIAGE�T OF
Y �ETR.0
HER 'AGFEET....PLW,THCIT AND STATE LAWS REGULATING CONSTR.0
THE OW - BE E LOYED
TION; AND IN DOINGTHEWORK AUTHORIZED THEREBY. NO PERSONWILL R E L AMTpl N G TO
I N VIOLATION OF THE LAS R CODE OF THE STATE OF WASHINGTON
WORKMEN-s COMPENSATION INSURANCE AND RCW 18.27.
.E.
z
VALUATION FEE
LAN CHECK PEE
z
o o I.>
0
I
B ILDING
0
PLUMBING
m
MECHANICAL
GRADINGIFILL
STATE SURCHARGE
ENG. REVIEW FEES
LANDS APING
INSPEC ION FEE
RECEIPT
PLAN CHECK DEPOSIT
R.EC
TOTAL AMOUNT DUE
APPLICATION APPRUVAL
Thil.ppill't- '� - - , ", ��o .� Vy-
CALL
BVI'dimo G .,d'F... .1. P..d, -d
1!�
FOR INSPECTION
wwg.� .. p-ld.d.
��
-
o ICIALS SONAT DATE
(425)
1 . "I"t I (I
"' D E
1
771-0220
RE ASEDBY
Ir 13,212
ATTENTION ' r-^ ---------
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTI
A FINAL INSPECTION HAS 13EEN MADE AND APPROVAL OR A CERTIF - 771-0221 ORIGINAL -FILE YELLOW INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
51.B