20000817.pdfDATE RECEIVED
7-/
FPERMIT EXPIRES
CITY OF EDMONDS
PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
—
JOB _0 11IT11AP11
ADDRESS _S 11,4�; -
OWNER NAME/NAME OF BUSINESS
PLAT NAMEISUBDIVISION NO. LOT NO. L�D NO.
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67>/&l 'qN r>s
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REQUIRED DEDICATION— 0
NO. OF FIXTURES PRV REQUIRED
0 Yes 13 NO
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REMARKS CO TRO E
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CITY
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PROPOSED
PROPERTYTAX�COUNT RCELNO.
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COMPLETE I EXEI T ALLOWED PROPOSED ALLOWED
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L I L_ r, , . 7a
PLANCHECKNO: oo__:;I07 7ESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BEDONEONPRIVATEP OPERTY ONLY. ANY CONSTRUCTION ONITHEPUBLRIC
DOMAIN (CUABS,SIDER LKS, DRIVEWAYS, MAROUEES , ETC.) W I.L. REQUI E
WA
SEPARATE PER.ISSiON.
PERMIT APILICATION: 180 GAYS
IS
PERMIT LIMIT. 1 YEAR - PROVIDED WORK STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
SSIGNS AND SUCCESORS
;APPUCANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, A
N NTE ' EST, AGREES TO �NDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
I s
2 EDMON WASHINGTONS TSOFFiCIALS. EMPLOYEES. AND AGENTS FROM ANYAND
Al-l-CiLAIMSFORDA.AGE OFWHATEVER NATURE. ARISING DIRE, � Ll - "'
FA M THE ISSUANCE OF THIS PERMIT I SSUANCE OF THIS PERMIT SHALL NOT BE
DEOMEDT MODIFYWAIVEO REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 DINANCE PROVISION
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY OR
I HEREBY ACKNOWLEDGE THAT: HAVE READTHIS APPLICATION THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT AM THE OWNER OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CiTY AND STATE LAWS REGULATING CONSTRUC
TION: AND IN 00 NG THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
RELATING TO
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
WORKMEN'S COMPENSATION INSURANCE ANDRCW 18.27�
SIGNATUR (OWNEROP BT
LAN CHECK FEE
B iLDING
PLUMBING
MECHANICAL
GRADINGIFILL
STATE SURCHARGE
ENG� REVIEW FEES
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
CALL
FOR INSPECTII
(425)
771-0220
ATTENTION r- A
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
�,98
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FOR INSPECTII
(425)
771-0220
ATTENTION r- A
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
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CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
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FINAL PROJECT APPROVAL FQRM
TO:
DATE:
M[EMO TO: pEMT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE—
GINEERING DIVISION DATE-6 ( LZEk-)
PLANNING DIVISION DATE —
SITE ADDRESS-
IRMNSPEC
PERM[IT it &W �O51 ADB#
DESCRIPTION OF WORK TO BE INSPECT
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
ectious from the above signed Department to the granting of:
there are no obj
________Yinal approval of the described work
___IZGRANT FINAL PROJECT APPROVAI,
GRANT pROjF
,CT APPROVAL WITH CONDITIONS NOTED
1.
. —FAILED FINAL INSPEcnoN - OUTSTANDING ISSUES
I
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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A*14-00 MON 02:58 PH FAX NO.
PACIFIC NORTHWEST'FITLE
. ..... ..... .....
UNIT 3
COVER PAGE?
FACSIMILE
FAX 425-551-4813
PHONE (425) 551-4823 (425) 551-4825 1-8M748-8109
ORIGINAL TO FOLLOW YES —NO
DATE:
ArIV.NTION:
ere -
COMPANY NAME,_
PNWT ORDER NUM13ER SNO—
rt WrA FROM:
-IV
"wrao
GEORGIA MARTIN, TITLE OFFICER
Of ovy,
K40LZI
tc�5�INDA BYLSMA, SENIOR TITLE OFFICER
P� 01
ABBEY POTTS, REALTOR ADVISOR
MMSSAGE: (1)aA 0�-
THANK YOU FOR CHOOSING PACIFIC NORTHWEST TITLE!
WE APPRECIATE YOUR BUSINESS!
PAGF ONE, OF— �-IINCLUDIKG 7MS PAGE)
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Ono benefit of $410 prcpar,los.
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repair or
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TAX
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STATE OF WASHINGTON I
Comw OF I
0. thl. dj, of 490,
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10, ; and hen n*cess3ry to rovd1r. �,loao or r:c,�nsttuCt
to this agroevot -Shot I hf�Q A right Q? OM!ry MW
that P�Ifvosd.
d: This d9rilvien? ith 'No Id'd j"d VW11
0 ding Pon oil h.l,*,.nd
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vrltyen.
TAX
REQUIRL
FEO 2 8
STATE OF wASNiNCiTW
COUNTY OF
Oft this day of 19MM8, piorsonally oppooir� Qrf so copov
7_ __ 'fr to we
isis
no
"c"W1062" t1wir signod sivJ it"led the some as free and voluntary act
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I havo hermoittl 60 L,1 hand 464 bttlx*d MY OfffClsf 9,141 th" day
this 4"IfiCiitis first wrl"MA. 01
15011L.1i; Praha Top r osovi5rWron
STANW41415-M )%a
COUNTY or
as this ftv 1060. bwmmf IV oomwf*d bal-w Ike
P
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing .............
Wall..........................
Pier/Porch .................
Retainirig Wall
Slab Insulation ..........
PLUMBING:
Underground - ............
Rough -in ...................
commercial Final
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING
I —is
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ...............
.ddh All,
40 jow 7
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CONSTRUCTION PERMIT APPLICATION
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LAT NAMEiSUBDIVISION NO LOT NO,
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6DIL-IoND-5 1"`�;�-77&-737-3
NAME
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ADDRESS
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ROP5RTY TAX ACCOUNT PA CEL NO. '-I--
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NUMBER
OF
N LIVER
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AREAS
NUMBER
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_STORIES
DESCRIBE WORK TO BE DONE
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FIRE REVIEWED By DATE
'RE REVtEWE D By
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ALLOWED PROPOSED
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ALLOWED PROPOSED
EXP I
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PROPOSED SETBACKS (FF.)
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REQUIRED SETBACKS (FT)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT URSIDE REAR
'ARKIN
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LOTAREA
N;�RVIP DATE
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REQUIRED
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FEE
PLAN CHECK
LOT
swc�
BUILDING
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PLAN CHECK NO: 00 _ :�o :7_ ESTED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT C I.E1111RC TO
BE DONE ON PRIVATE PROPERTY ONLY. AN CON57.1 CIE.. ON T PUBL
,
GRADINGiFILL
LKS, DRIVE S, MARQ EE! . T,,., WILL ED., E
DOMAIN (CURBS. SIDEWA WAY
:1 SEPARATE PERMISSION.
-
STATE SURCHARGE
PE mITAPPLICATIO ; 10"S
R N
PERMIT LIMIT, I YEAR ' RK S, STARTED WITHIN i8QDAYS
PROVIDED W. I
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
;A PLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
Y, DEF No AND HOLD HARMLESS THE CITY OF
PINTEREST, TO MDEMNII 5
ENG. INSPECTIO . N FEE
6AND68—ING
N AGREES
2 EDMONDS� WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM �NYAND
I�e�EE
E N . E
ALLCMMS FOR DAMAGIESOFWHATEV R ATURE ARISINGDIR C LYCRII,IDIRECTLY
THIS PERMIT SHALL NOT BE
RFc E T/
DEPOSIT
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF
DEEMED TO MODIFY, WAIVE 08 REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
ANY ORDINANCE PRoVIStON.'
PLAN CHECK
RE
I T
I NOR LIMIT IN ANY WAYTHE CIT Y'S ABILITY TO ENFORCE
T TAL A.OUNT DUE
I HEREBY ACKNOWLEDGE THAT' HAVE READTHISAPPLICATION� THAT THE INFORMATION
OULY AUTHORIZED AGENT OF
A P LtqATION �PPROVAL
-',.,v.-y-
HE
T. AND THAT I AM THE OWNER. G CIDWSFi
GIVEN IS CORREG 0" T LAWS RE
Y AND STATE .1.1-AlIN
CALL
I ` —a
D ,,d F111 Old.
THE OWNER. I �a TO COMPLY WITH Cl
REE NO PERSON WILL BE EMPLPIC�
T EREBY.
pty.
F—W-
TION, AND IN Dol NO THE WORK AUTHosIzED
IN VIOLATION OF T H E L CODE OF THE STATE OF WASHINGTON RELATING To
ABoR
FOR INS PECTION
WORKMENSCOMPENS ATION INSURANCE AND RCW 18.21.
o,OT�
AIE SI
N ED
N:ATOU (OWNER OPQCGE-D-1), _
(425)
771 -0220
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IELIASED 1 'DIE
_II]ID
EXT? 333
"),Y
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILINNG OR STRUCTURE UNTIL
771-0221
-o.
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI-
RIGINAL FILE YELLOW INSPEcT6R
GOLD - ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK OWNER
5198
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