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20000872.pdfDATE RZCEIVEO PERMIT EXPIR US E USE PERMIT FEDMONDS CITY OF EDMONDS �N N �.IIE - �)) NUMBER P M PPL, CONSTRUCTION PERMIT APPLICATION ER JAO 0 JOB SUITEIAPT# ADDRESS DO S OWN OF BUSINESS PLAT NAMEISUBDIVISION NO, LOT NO U 10, LID FEE S WITACATION MAILING ADDRESS lEllP PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW _AP -11 CIT ZT TEL PHONE EXISTING — PROPOSED-- XI roov 9'�J) REOUIAEDOEDICATION— ;T M5TER SIZE LINE SIZE NO,OIFI.TUR. PFIV REQUIRED NAME I 'El 0 NO 0 I ADDRESS P MARKS E' 0 0 WNER..NTRACTOR RESPONSIBLE FOR EROSION C.NTR.IIDRAtNAGB Em ADDRESS CITY ZIP TELEIIION STATE LICENSE NUMBER EXPIRATIONDAT�E I CHECKEDBY —PLUMBING 0 NEW Er I MECH C3 ADD17ION c3 C MPLIANCEOR CHANGE OF USE REMODEL 0 SIGN GRADING PENCE E;J"REPAIR C3 CYGS 0 — X 0 DEMOLISH f-I TANK o OTHER oGARAGE CARPORT r-1 RETAIN.INGWALL - ROCKE E] RENEWAL (TYPEOFUSE.� ACTIVITY) EXPLAIIN: �SINESS L_ - — �TUMSER TNUMBER OF CRITICAL OF DWELLING R �AEAS R STORIES UNITS U N UMBER�� DESCRIBE WORK TO BE DONE THS.,ERMT AUTHORIZES ONLY I HE WORK NOTED* THIS PERMIT COVERS WORK TO E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC ICU . SIDEWALKS. DRIVEWAYS ARQUEES. ETC.) WILL REQUIRE SEPARATE PER�ISSION. PERMIT APPLICATIOW 160 DAYS PERMIT LIMIT. I YEAR ; PROVIDED WORK IS STARTED WITHIN 180 DAYS SEEBACKO PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS' WASIHINGTON� ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND ALLCLAIMS FORDAMAGE OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMEDTO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CII Y'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - FIRE REVIEWED By DATE VARIANCE OR CU SHO ELINE OR ADB# INS.P.E.C,"ON 'BOND STED OYES ON. SERA REVIEW SIGN AREA HEIGHT C EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED ,COMPLETE I XP I I LOT COVERAGE REQUIRED SETBACKS IFT.) PROPOSED SETBACKS (FT) ALLOWE 0 PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR PARKING LOT AREA I PUNNING REVIEWED BY _7ATE E CK E . Y I UE, OF C �N.TN -,-_T I QI , -'.�-.U.PpAD Z _ _ J��,r SPECIAL INSPECTOR JAREA REQUIRED E] YES L OCCUPANT LOA REMARKS PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D F. VALUATION FEE PLAN..E�KIEE BUILDING PLUMBING MECHANICAL GRADINGIFILL STATE SURCHARGE ENG. REVIEW FEES - :�- ') 0 . I - - LANDSC ING INSPEC 11 N FEE PLAN CHECK DEPOSIT RECEIPT TOTAL AMOUNT DUE RECEIPT -_I I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT HEINIOFIMATION APPLIC ION APPRO L GIVEN IS CORRECT: AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF EOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL T -ppikat'o. p,,,,i �W llpld by 11 1 dIlgOil-1111-1hl O,pjy.:P'd Fool- d. h TION. AND IN D ING THE WORK AU HOSIZED THEREBY� NO PERSON WILL 89 LEMPLOYTED 0 TON RE ATING OF WASHING 0 FOR INSPECTION rocwpi is acknowladg providod. IN VI 1 LABOR ODE OF THE STATE OLAT ON OF THE C WORAMtN'S COMPENSATION INSURANCE AND RCW 18,27. FFICIALS SIGNATURE DATE IGNED (425) 771-0220 RECEASED By ATTENTION EXT/333 IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 9 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE - YELLOW INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK OWNER - GOLD - ASSESSOR 5198 z 0 m C C, L rn 0 40 0 C m M m r___4 �2; ; � O_n n rn rn 0 0 0 cl C ca M 0 X z -4 z 9 0 rn RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall.......................... PlariPomh ................. 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 SNEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR I OCCUPANCY .................. -2 z: 0 0 IT, C rn 0 80 C M JD 0 -n ITI M 0 0 0 Q 0. Z Z� —1 z 0 I M DATE RED IVED PERMIT EXPIRES PERMIT ;zouc 72- v CITY OF EDMONDS j6NE NUMBER CONSTRUCTION PERMIT APPLICATION JOB ADDRESS OWNERNAME AMEOFBUStNESS PLAT NAMEISUBDIVISIO 1)"7Z ck W, L10 FEE S , �d MAILING ADDRESS ()L SUJ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED I .1 d CITY rd ,p TELEPHONE nio 577 zs REQUIRED DEDICATION— FT — NO, OF FIXTURES w PAY A EQUIRED NAME YES 0 NO 0 TELEPHONE FIRE REVIEWED By DATE IP TELEPHONE CITY VAR1111 CE OR CU SHORELINE OR ADBN INSPEC!DION BON RED POSTED EXPIRAHUN— CHECKED By OYES ONO N REA SERA E IE SIG POSED P 0 ALUO,E HEIGHT 0 PROPOSED COMPLETE E E PT ALLOWED PROPERTY TAX ACCOUNT PARCEL NO. 6 0 XP I LO C ERAGE EQUIRED SETBACKS (FT) R OVPROPOSED SIDE FEAR ACKS (FT.) PROPOSED SMSIDE REAR FRONT U gwe RE IDENTIAL �PLUMSIING I MECH ALL.WIED FRONT 0 NEW AODITION 13 COMMERCIAL o COMPLIANCE OR CHANGE OF USE PARKING LOT AREA P NNINGREVIEWEDBY - DATE 0 APARTMENT 0 SIGN REO'D I PROVIDED REMODEL U,KE' 0 GRADING YGS FENCE 0 1, X FT) REMARKS n DEMOLISH — D TANK o OTHER ARAGE 06 ED] RE ININGWALL C FRY C D RENEWAL CARPORT (TYPE OF USE, BUSINESS ACTIVITY) EXPI-AIN: CHECKED BY E IF C N TRUCT11 N E OCCUPA GROUP OCCUPANT NUMBER 0 CRITICAL Ul SPECIAL.INSPE Ull LOAD BER DWELL NG AREAS NUMBE R REQUIR D r-1 YES RIES UNITS' ESCRIBE WORK TO BE DONE REMARKS- ...,N, PrR UBC 1081FINAL INSPECTION RE( "Li�hL� J1(:AR PLAN CHECK FEE HEAT SOURCE GLAZING I LOT SLOPE I BUILDING VESTED DATE PLUMBING AN CHECK NO: MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTE' PERMIT COVERS WORK TO TRUC,QN ON J.� PUBLIC GRADINGIFILL BE DONE ON PRIVATE PROPERTY ONLY. ANY SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE DOMAIN (CURB% SEPARATE PERMISSION. _- STATE SURCHARGE UNIT' I YEAR "" IS HIN ISO DAYS END. REVIEW FEES I; PROVIDED PERMIT 'BE BACK 0 NK PERMIT FOR MORE INFORMATION S APPLICANT. ON BEHALF OF HIS OR HER SPOUSE HEIRS. ASSIGNS AND SUCCESOR I �No HARMLESS THE CITY 0 LANDS ING Y DEFEND HOLD IN INTEREST. AGREES TO:TNDEMNIGFI�LS EMPLOYEES ANDAGENTS FROM ANYAND INS PECTI N FEE OFF N ECTLY OR INDIRECTLY F.FGA.AGE� OF WHATEVER NATURE, ARISING DI EDMOND'SWASH'MGTO RPERMIT SHALL NOT BE F PLAN CHECK DEPOSIT ALLC,,N LANCE OF THIS FROM THE ISSUANCE OF 'HIS PEERIM,TEA'N`YREO REMENTOFANY.IIYORDINA Cl I BEEME ..... IFY�WAVER ABILITY TO ENFURCE A14Y ORDINANCE PROVISION ,Ty% AMOUNT DUE ,G'L,MITINANYWY,. TOTAL I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS App,,J�CEA�GONY. THAT THE INFORMATION L TH.R'Z. AGENT OF ULY AU 0 G CRT IECT; AND THAT I AM THE DINER OFATHE GIVEN 'SCOR' REG T ONSTRU C WITH CITY A . ST TE LAWS ULA ING CE CALL ,HE OWNER. I ...E TO COMPLY P OYED THE WORK AUTHORIZED 'HERESY 'ERS�.N WILL F L . To RELAT N FOR INSPECTIO1 TIOWANDINOOIN IN VIOLATION OF THE LABOR CODE OF TH E STATE OF WASHINGTON WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. (�25) ........ S tREIOWNEROPOENT) ED 7-T � 0 (l 77'*0220 7, 1 pa jo ATTENTION OR STRUCTURE UNTIL 771-0221 IT IS UNLAWFUL TO USE 08 OCCUPY A BUILDING AND APPROVAL OR A CERTIFI- A FINAL INSPECTION HAS BEEN MADE GRANTED. UBC SECTION 109 FAX CATE OF OCCUPANCY HAS BEEN am VALUATION FEE ck.") v 0 PT PT APPLICATION APPROVAL .,kmW,dU,d �n pr—dod. DATE FFICIALS SIGNATURE Lt- OAT E EeEASED BY ORIGINAL -FILE - YELLOW INSPECTOR PINK - OWNER - GOLD - ASSESSOR z J m =I �n c: m 0 00 c m m z fill 0 -n n m M 0 o rm- C= co 9 co) M 0 Z r- z z 0 1 0 m