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20000837.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION MAILING ADDRESS 9!/B O/ ri CITY ZIP---�TE-LEPHOHE C'1onGfS 9�ozlo I �fas-�7v-o9Co9 I l ADDRESS ESS 'l 26 tic./ rt CITY ZIP TELEPHONE ���vDC� it�ft '7 NAME a ADDRESS 0 tt CITY ZIP TELEPHONE O U STATE LICENSE NUMBER EXPIRATION GATE CHECKED BY -r PROPERTY TAX ACCOUNT PARCEL NO. /f3z7oN-Z-oo�}-©00.7 NEW dRESIDENSAl (Xl PLUMDINGIMECH J� COMPLIANCE OR eADDITiON ❑ COMMERCIAL ❑ CHANGE OF USE ❑ REMODEL ❑ APARTMENT ❑ SIGN �} GRADING FENCE ❑ REPAIR `Y� n � CYDS ❑ i NCI X FT7 0 DEMOLISH ❑ TANK ❑ OTHER IJ CARPORT GARAGE ❑ ROCKIFRYG WALL ❑ RENEWAL �r F (TVPE OF US'c.BUSIi S ACTIVITY) EXPLAIN: c NUMBER [ DWELLINQF AREASCRITICAI���/!/ C STORIES ✓` UNITS NUMBER DESCRIBE WORK TO BE DONE gr�,6L>c+x wT�'Gt lP7�i . &is , S� P ✓ a✓ 6e d/sass�hlvc/ o�' Yh o PERMIT EXPIRES 1& -C 1 + sE PERMIT �•y DNE S �_._,. NUMBER DD ^- SUITHAPTn n M , / bORESS 9118 d/I'N U/G l/(8a+/ DY/NO PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. I LID FEE S PUSLIC RIGHT OF WAY PER OFFICIAL STREET MAP TEscPAa ,q." I P s d� EXISTING PROPOSED off I REQUMEDDEDICAT10N FT UM ro a drq METER SIZE LINE SIZE NO.OF FIXTURES PRV REOUIRE0 YES O NO O REMARKS nwrvcR ,TRArTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE FIRE REVIEWED BY DATE YES SERA REVIEW COMPLETE EXEMPT !XP SIGN AREA ALLOWED PROPOSED H ALLOWED LOT COVERAGE ALLOWED, PROPOSED REOUIRED SETBACKS (FT) . FRONT SIDE REAR PROPOSED FRONT L ME PLAN CHECK FEE HEATS URCE GLAZING LOT OP BUILDING PLAN CHECK NO' DATE VESTED PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL BE DONE ON PRIVATE S DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. STATE SURCHARGE Y PERMIT APPLICATION: 180DAYS YEAR- PROVIDED WORK IS STARTED WITHIN ISODAYS ENG. REVIEW FEES PERMIT LIMIT: t SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND BUCCESORS ENG. INSPECTION FEE IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF AGENTS FROM ANY AND A �P FEZ f EDMONDS, WASHINGTON, ITSOFFICIALS.EMPLOVEES.AND WHATEVER NATURE. ARISINGDIRECTLYORINDIRECTLY iN6PLCTtON R' ALL CLAIMSfOR DAMAGE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SMAII NOT GE PLAN CHECK DEPOSI DEEMEDTO MODIFY, WAVE OR REDUCE ANY REOUIREMENTOF ANY CITY ORDINANCE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- R _ rvOR LiMiT INANY WAYTHE TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION OWNER, OR THE DULY AUTHORIZED AGENT OF GIVEN IS CORpECT: AND THAT I AM THE THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- BE EMPLOYED CALL TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL THE STATE OF WASHING'rON RELATING TO FOR INSPECTION IN VIOLATION OF THE LABOR CODE OF WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27, SIGNATURE 1 WNER GEN DATE SIGNED (425) 771-0220 I' ATTENTION Q EXT 333 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 E198 10 D GROUPA 3 1Mn: OCCUPANT _. LL1�7AV1 LOAD PER UBC 1081FINAL INSPECTION RE.' lof2-j W254 VALUATION FEE GG �D so This appiicalipn is nai a permit unlit signetl by Ihp Buiitling Oiliciai or hislhar DopNy: and Feas aro pattl, antl roceipl is acknowipdgptl in apapo pravitlptl. OF FIALS SIGNATURE DATE R ED BY DATE ORIGINAL FILE YELLOW • INSPECTOR PINK OWNER GOLD -ASSESSOR z O o rn cm mo -1 '0 Oc mm m:� D z r= N m m Ow G N ri m(R D z co O n m FINAL PROJECT APPROVAL FORiAI TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE h. Entt BICLT ENGINEERING DIVISION DATE l a'3 PLANNING DIVISION DATE PROJECT S� t rnti f 7" SITEAUDRESS qj(o' OVA // PERMIT # bOO g ` d ? 9 `7 ADB# DATE INSPECTED (o l l a . DESCRIPTION OF WORK TORE INSPECTED Lt tJ }l t-- A field inspection was conducted to determine final compliance with approved plans. Final; approval' denotes- that there are no _ objections from. the above signed Department to the release - of PERFORMANCE BONDS and the granting of C./ GRANT FINAL. PROJECT APPROVAL GRANT PROJECT AFri JV AL WITH CONDITIONS NOTED o Copy of CONDITIONS given to owner/contractor by inspector 1. FAILED FINAL INSPECTION - OUTSTANDING ISSUES a Copy of CORRECTION NOTICE given to owner/contractor by inspector L 2. 3. OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL RE -INSPECTED Date__.Sign maprvl.doc.l:wmp:bldg:focros l0/01 z 0 n m cm MO �O 0 iM mz A '{ DZ o-n mm_ oU' r m e' 7'1 i i z x w 0 i 0 m ..;,o,ar �r,.3�r.. r,...��5�,.,, F, n. at. .ani r. �.�r, �,;�..., ,�. ... „..., ;,..;..� ,e,y.),t ;;.-., y!v::74 n �I - DATE RECEIVED ( , IVO PERMIT EXPIRE&' t� u'HE PERMIT CITY OF EDMONDS Z°"E S- _ NUMBER Z CONSTRUCTION PERMIT APPLICATION DD BDITFAPTN ADDRESS / OWNER NAME/NAME OF eUSINESS // PLAT NAMEtSU801ViSiON N0, LOT NO. LID NO. `r �Wk / LID FEES 6 MAILING ADDRESS / i[scra rovne I`.—.e p /,tom PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Rw cer (�l (f ` � p _ uRapa �pegvi /N O EXISTING PROPOSED ee CITY 21P TELEPHONE we O ,/l� �L� EOUIRED DEDICATION FT uMargrouna Gl /[/vt Wlrin9 eo4uoae ( c NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED O ❑ ❑ YES NO Z ' '- _NTRACTOR z ADDRESS .. REMARKS RESPONSIBLE FOR EROSION CONTROVDRAINAGE ... l(,)?u./m4xF r[//c7S CIT,,Y// Y/ 4�7�L/..l l�l/'>"f :- - -':�� �� G�• .. r'! /A)//% • L, ko-h; 7 S tYK- NAME _ .(C/ CM //'(Y/l111S/i^ cc!-/"MrAN. /Nl i' Ib,G. Z ENGINEERING O ADDRESS I11 FIRE REVIEWED BY DATE 1 Fi CITY ZIP TELEPHONE T O U '. VARIANCE OR CU SHORELINE OR ADBp INSPECTION BOND STATE LICENSE NUMBER EXPIRATION GATE CHECKED BY r�� ���. ❑YflSQ 0 POSTED ce C M SEPA REVIEW SIGN AREA HEI HT PROPERTY TA% ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED' ALLOWEDf PROPOSE` EXP m O _ J U, m Z i y( LOT COVERAGE REQUIRED SETBACKS (FL) PROPOSED SETBACKS (FT) (�E,N RESIDENTIAL (J{I PLUMBING t MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT. US SIDE REAit' COMPLIANCE OR O C Z eADDRION ❑ COMMERCIAL ❑ CHANGE OF USE PARKING LOTAREA PLANNINGREVIEWED ❑ REMODEL ❑ APARTMENT ❑ SIGN REQ'D I FENCE ❑. REPAIR GR I CYDS ❑ ( X FT)) MgRKB tldhi7ort C•dsln e- b ✓C G( etn,dZ}N T 6+d R IRkr c�trd� yvnle55 /+� A»eef5 rule /«�S, .❑ ❑ DEMOLISH ❑ .TANK OTHER -4 F}j/GARAGE I RETAINING WALL RENEWAL / ,y, / �( EeD• IJ CARROTY . ❑ .. ❑ ROCS %T I7iCC! Id CSC/'/ �4 LIGl9CGl� Q !; Q N C• (A tI- G (TYPE OF USE BUSINESS OR ACTIVITY) EXPLAIN: CH KE BY TYPE OF CONSTRU JIOfj D GROUPA"T �'- { cA o Zr. NUMBER OF OWEBLINGNUMER F AREAISAL/� �,></ SPECIAL INSPECTOR OCC AREA C,�A.CLPI['1J(J LOAD PANT n O STORIES ✓ UNITS NUMBER REQUIRED ❑ YES R� DESCRIBE WORK TO BE GONE O REMARKS �` PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D o = 3 // I ', // // G �Y/ // lt< p � \ /�R �. / L S d � YPt'T_W 71-' '14y.5°'-WI/i.7 /IU/Y'1 t x (y U! O L / - TU 6� >;il5Ls5rt'i1,��UG/ aY �Gr/4 C,-OItiYT g aU; 0 1'(IALBATION. FEE cS'S 5 PLAN CHECK FEE HEAT SURCE� LOT BUILDING - �AGLAZING �('TJ_ -� PLAN CHECK NO} VESTED DATE PLUMBING •� ^(� MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 1 BED UN PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC REQUIRE GRADINGIFILL ' = DOMAIN iCURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL SEPARATE PERMISSION, STATE SURCHARGE 5� PERMIT APPLICATION: 1800AYS�l PERMIT LIMIT.I YEAR• PROVIDED WORK IS STARTED WITHIN TBOOAYS ENG. REVIEW FEES - SEE BACK OF PINK PERMIT FOR MORE INFORMATION _. ON 85HALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS ES TO IN05MNIFY FEND AND LD HARMLESS THE CITY OF ENG. INSPECTION FEEEPLICANT. U, ' IN INTEREST, AGEE ANY AND ND FIT M ED EMPLOYEE&SING I NSP �/fL�? DAMAGES OF WHATEVER EV RE NATUREE,, ARIIICIALS, CLAIMS FORDIRECE OF THIS TLY RIT INDILL REC LY BE NC�FI�ECK'DEPOSIT RECEIPT `.�'./(,JAL �• ', FROM TO MODIFY, WAIVE REDUCEANY REQUIREMENT OFANYCITYPROISIONE DEEMED iNOR LIMIT IN ANY WAY THE CITY'SABILItY TO ENFORCE ANY ORDINANCE PROVISION.` IT TOTAL AMOUNT DUE RECE h , I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION '�nn I• W 11101 APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE OULV AUTHORIZED AGENT OF rhls aPWcrdion unmxParmn �mn s-Pmd nv lno THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC . (',ALL a id 0011,-IorK h DPIY' and Foas ura D�tl and TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED WASHINGTON RELATING t0 FOR INSPECTION PI's aFk d0 drn 11� Prov dod. IN VIOLATION OF THE LABOR CODE OF THE STATE OF WORKMEN'S COMPENSATION INSURANCE AND RCW 18.2i. �q4 OFFICIALS SIGNATURE i DATE SIGHATUFlE WNER .AGE ! DATE SIGNED �' 42 ,/( �11 7{1-0220 RGL ED BY F OATS ATTENTION r x C �/ c-a1/,-7°' EXT 333 ,, <-r7 r 0& IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771 -0221 r"- ' O YELLOW. INS A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- r ORIGINAL OVr'NEfl • GOLD ASSES -J 1.71f CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 10 }�� 41207!?� 10�17�U2 �� PINK -OWNER iq V 21rt5 CIJ�7t3� 4°�� 9e Yr�fiUtQ� Q'j