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20000904.pdfCITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINE MALING ADDRESS pn 7", CITY ZIP I TELEPHONE - PERMIT EXPIRES U USE ERMIT _o"� S ZONE 2- NUMBER '0. SUITFJA A C .. DDRESS '��,T NATt/DIVITt 11 NO, LOT 1,10�2 LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 11 p:': EXISTING - PROPOSED R.'a. REQUIOEO DEDICATION- IT q MET= LINE SIZE NO. OF FIXTURES .2--,?- ff�_: PRY REGI , YES'K R MARKS OWNER-0- ... - -E-1-81E FOR EROSION CONTROUDRAINAGE NO 0 e--r2 4D CITY TELEPHONE NAME EN INEERING HE E Iwo 4) m ADDRESS FIRE REVIEWED By DATE ITY ZIP TELEPHONE a VARIANCE 0" OU SHORELINE OR ADS# INSPECTION I BOND E LICENSE NUMBER EXPRAT ON DA E CHECKED BY ON AREA EI..T SERA REVIEW COMPLETE EXEMPT ALL ED ALL ED POP PROPERTY TAX ACCOUNT PARCEL NO. 4= Gy"PLU.... I LOT COVERAGE REQUIRED SETBACKS JFT.) PROPOSED SETBACKS (FT.) FRON I FRONT UPSIDE FEAR RESIDENTIAL ALLOWED PROPOSED 9,:!r ADDITION COMMERCIAL COMPLIANCEOR cl CHANGE OF USE 'v I PARKING C] REMODEL APARTMENT C] SIGN R OV FENCE CO3 REPAIR CYOS 11 ( - X FT) C] DEMOLISH C] TANK C] OTHER AFA.- RETAINING WALL 0 RENEWAL R C:] IdCARPORT F C ERY. K 0 (TYPE OF USE, BUSINESS OR ACT r CCUPANT COICKIDBY Cq- A. M ITIPEOFCOISTIRUCTION AD GROUP A I NL BER OF OR UM NUMBER IN ITICAL DWELLIN 0 AR AS SPECIAL I.HnCYTEOR OCCUPANT LOAD OF o STORIES UNIT. NUMBS R FEDU E IRE IfAs '7 TOE E DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PE BID 10MINAL INSPECTION REO'D _77 �51 Is I AA5JA1 VALUATION FEE PLAN CHECK FEE OT S OPE % Inc) BUILDING PLAN C14ECK N?W_ PLUMBING zuo 1111,EDDAI VV MECHANICAL o THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL 110 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REOUIRE SEPARATE PEZISSION. STATE SURCHARGE PEA IT APPLICATIONt 180 DAYS M PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENO. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION ON BEHALF OF His OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS ENG. INSPECTION FEE ;APPLICANT N I NTEREST. ACRE TO :NDEMNIFY. DEFEND AND HOLD HARMLESS 7HE CITY OF ES AND LANDSCAPING 2 EDMONDS, WASHINGTON, TS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY 5 ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY INSPECTION FEE FR M THE ISSUANCE OF TH S PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 0 1 REDUCE ANY REOUIREMENT.F ANY CITY ORDINANCE I OEEM5DTo MODIFYWAIVEOR PROVISION. 0 NOR LIMIT IN ANYWAYTHE CITY'S ABILITYTO ENFORCE ANYORDINANCE TOTAL AMOUNT UE RECEIPT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION APPLICATION APPROVAL H DULY AUTHORIZED AGENT OF GIVEN IS CORRECT. AND THAT I AM THE OWNER OR T E CONSTRUC Th', 1pol-t-11 111-1 1 P-it 11119- by thl THE OWNER AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING WILL BE E MPL.YED CALL SON, g oil,F., .ty: - F - p,d. TION AND IN DOING TH=CAODHORIZED THERE BY, NO PERSON STATE OF WASHI NOTCH RE LATING TO F OR INSPECTION ..pdgD 1-0111pl-d1d. E IN VIOLATION OF THE OF THE �211KMINI COMPENSATION INSURANCE AND RCW 18.27. (425) OFFI I L NAT DATE -1� I S, DATE SIGNED E (OWNER OR AGENT) 771-0220 AELEASE tAT4 EXT 333 NTION ITI UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 AND APPROVAL OR A CERTIFI- RIGINAL FILE YELLOW. INSPECTOR INAL INSPECTION HAS BEEN MADE CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR SmB z m 0 m c 0 m 0 80 a rn m z 10 0-11 n --I 3: m M 0 0 0 c m 0) co M 0 Z z -4 X z 0 m bfZA—J"�T- ?��PDP-T- FDt�- AJSr74LLA-�Aj Al & ys r�--� A,,' 0 Zxo-s- J co A-7f�t— RECEIVED 17 1999 UEVELOP "ENT SERVICES CTR. CITY OF EDMONDS -11-30 Kf*5-ep- kAEk4l�4-i e-bLr-uLfM0Q5- NIL CoLsJf-iL -8.00 w'.3 coe-PtA- R-70 5f- dowr= it $!- 60 4. Sw Co a-IJ �-& -11-00 Ile-",jvtA 4twoir- - cl. 3a� 'DtkT"um POIX)T' e- M&O *OL.9- ctousx 0-co M&)c ow vi E 26*0 CA00'0W%(lWr'"B'ZoS () 0. -aox a-ct jg�tnoo'a,s %,ejA, '1802Z \-S60,L De-5C Lk 9 rig Q.* Wtc-SL, 2- itr CiTr Or F, 0�lt)s tmoex ezo-,6- 'c= 6 0 D 5- ""4, 71 , P6 QrvcoVjVl QgMp- FvI.>b,T-0&:5 XLLC- 0� - QqoZ.%!T0Z316. 'AWOZZ-" jt,r 6%��ffit5t* 1-i pt)v I - INSPECTION RFOUIRED % y AP �ECEIVED AF DY f��N N I MAY :U' 5 2009 DEVELOPMENT SERVICES CTR. fo, 00 CITY OF EDMONDS RIGHT-OF-WAY CONSTRUCTION PERMIT AND INS2EGII e- oco ENGINEERhC ��,'.OTFFT - - ---- -------- 0 i 0, 51, M m -q 00 1 a m m z c: 0, n -1 i m 0 v 0 r- 0 C: ME z z m - ----- ------ 1 Y A�l' 7e Al y.5 r-e 0 -S—,J C'r )o 00.01LIPSL - T. 60 4. SZW C40 �-X - 4.00 r",5 0410 _Dt"_,Jtq po 'Dhilutl c'; ML ZL rn ow Q f- PS*. CA00'0VJX(,IkT"6A0S 0 o Im RECEIVED S�ai-jooj>,' %,.4A. q8020 MID 0 -40 0 0 a 17 1999 --i R mm OEVELOPMENT SERVICES CTR. CITY OF EDMONDS m z c > -6.00 cr or (n 0 in 4f a J* MM 1 P6 r%coLing) UA s 0 r ca ma z X, INSPECTIOM PFOUIRED > z z 0 m is 9$4HAW4fJPL)S7- fo.00 fil HT -OF -WAY CONSTRUCTION PERMIT AND INSPECII 0 e- ENGINEERINC L Project Review Checklist Plan Check #: ProjectName: Receipt Date: Project Address: Underground Wiring Required Hydraulics Permit RECEIVED Plat/Subdivision Requirements MAR 0 7 2000 z 0 Street Dedications Easements - Public/Private Engineering Storm Drain Review Feel PUBLIC WORKS t.) 3 Engineering 2.2 Inspection Fee Drainage Plan (On -site) 55 Setback - Storm Drain Line Existing Oat C rn 0 0 Open Ditch -. CO -40 0 Culvert Required C culvert Size Shoulder Drainage/Shale Open R-Off M M z 0-1 catch Basin Required C= 2 Driveway Slope & Vehicle Access Sidewalk Required 0 _n Curb & Gutter Required n Curb Cut for Driveway Required -4 Street Paving Required MM Right -of -Way Construction Permit Required 0 Bond Required for Public Improvements 0 C co FEMA Map Check/Water Table 9 M Side Sewer Availability calculate Sewer Fee ifNQ LID# Water Meter Size Water Meter Charge Required z Hydrant Required Street Cut Cn Miscellaneous z 0 M RW Permit # Date Issued Receipt # 33 Date Issued Receipt # Cf SS Permit # Fire Connection$ Date Issued Receipt # Paid $ 21-0 C) Date 14*)(_� Receipt # -1 Meter Size RECF_IVED FINAL PROJECT APPRO.)-VALFORM KI 2 - 20 MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION TO.-f 1� DATE:_ FROM: FIRE DEPARTMENT DATE— ENGINEERING DIVISION DATEI�21 �Q z 0 i nAsesm PLANNING DIVISION DATE— 0 PROJECT M C MO 0 SITE ADDRESSL bz1-9 0C -4 r. MM MZ PERMIT 4 _____PATE INSPECTED jo DESCRIPTION OF WORK TO BE INSPECTED z A field inspection was conducted to determine compliance with approved plans Final approval deno tes that artm the granting of: si edDep, ent to 0 n n there are no objections from the above gn M M approval of the described work 0 0 —Final GRANT FINAL PROJECT APPROVAL Q 0 Z GRANT PROJECT APPROVAL WITH CONDITIONS NOTED lospemoml- 'DOWIF, 0y �fi76,V- 6Tff-F- 09CW > z FAILED FINAL INSPECTION - OUTSTANDING ISSUES z 0 M 2. 3. RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL ocaprvl.doc.l:ternp:bldg:fomis6/98 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... -0,0 Z' Wall.......................... S Pier/Porch ................. 0 Retaining Wall ........... Slab Insulation .......... PLUMBING: rn M 0 0 Underground ............. 0 Rough -in ................... IT IT! Commercial Final HEATING: Gas Test .................... 0 -n -n Gas Piping .............. La Equipment IT ................. Final �2 Commercial 0 fn EXTERIOR SHEATHING C co) NAILING .......................... M 0 Z r- FRAMING ........................ FIRST FLOOR FRAMING ANSULATION .................... z Floor msulation 0) Wall Insulation ........... z Calling Insulation SHEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. 0 (DATE 310E�§ � I PER�IT 615IRE�' PERMIT CITY OF EDMONDS. NUMBER CONSTRUCTION PERMIT APPLICATION AUITEIAPT#3 'A'DCRESS )-2, ��Ell OAMEANAME OF 5USNII� rnb AJ I If- N -7 A K, F T H�Tl��BDIVI§Jre� I LOT NO LID NO. L'D FEE MAILING A DRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAI P TESCP API .......... s.= P AD A00 CITY "P EXISTING PRO POEED�— 0 A$ �ELE_ REQUIRED DEDICATION� FT — I=- q F FIXTURES P DURSO P � ED RED R V )z NAME YEE NO 13 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR ER. SION CONTROLDRAINAGE ADDRESS J� 'jkl d4 Ids — 7ldl-) A��e U 13 CITY "__IP I 244 o I I I= ADDRESS FIRE W6BY' DATE zip TELEPHON CITY E �w L I, ;' ': ". VARIANCE OR CU SHORELINE OR ADB# iNSPECTI N 60 D POSTED STATE LICENSE NUM ER EXPIRATION DATE CHECKED By REGO 0YES—oNO_j �j A SIGN —AREA HEIGHT - co �N,, . �k COMPLETE_, EXEMPT ALLOWED PROPOSED ALLOWED PRoPOSE5 LOT COVERAGE REQUIRED SETBACKS (FF.) PROPOSED SETBACKS (FT) RESIDENTIAL PLUMBING I MECH ALL DV!�D PROPOSED SIDE REAR FR?�V SIDE RE�5 C MPLIANCE OR C] ADDITION COMMERCIAL co E] HANGE OF USE 'ZINT ED By C] REMODEL APARTMENT SIGN PARKII LOTASEA Pi NGRSAft �,DATE F NCE 0 REPAIR cyos x EMARK—, DEMOLISH C] TANK o OTHER CRf/l ARA.E STAINING WAI , 2 OFT CK Ry CARP ED (TYPE OF USE. 8USINES OR Ac�lvl CHECKED BY TYPE OF CONSTR.-- GRO P D NUMBER N BER OF CH TICAL SPECIAL INSPECTOR OCCU NT LOAD F U 0 Z BILLING' AREAS R (2Q STORIES NUMBE REQUIRED Eo] YES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS P INSPECTION REQ'D i A, 4�vwl d �lr_ VALUATION FEE 05 PLAN CHECK FEE OT SLOPE I HEAT SOURCE A C4A-, /'� Z", % sv. BUILDING PLAN CHECK NI PLUMBING MECHANICAL THIS PERMIT AUYHOH'zn ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I BE DONE ON PRIVATE PROPER" ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFIl-L DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE :3 SEPARATE PERMISSION. I: STATE SURCHARGE I T APPLICATION: 180'DAVS. PERM PERMIT UNIT. I YEAR -PROVIDED ORK 15 STARTED WITHIN 180DAYS ENG. REVIEW FEES IT FOR MORE INFORMATION SEE BACK OF PINK PERMW PLICANT. ON BEHAL F HIS OR HER SPOUSE. EIRS� ASSIGNS AND SUCCESOR5 THE CITY OF ENG. INSPECTION FEE ;A NI INDEMNIFY. DEFEND AND HOLD HARMLESS III TEREST. AGREES T iTS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND NO IN "I&W2 BDA DIRECTLY OR INDIRECTLY LANDSCAPING INSPECTION FEE R NATURE, ARISING ALLMlolo NITAQ E�.'.-ATEVE PERMIT ISSU NICE OF THIS PERMIT SHALL NOT .2 PL N CHECK DEPOSIT RECEIPTJ(�/S FROM THE ISSUANCE OF THIS - DEEMED TO MODIFY, WAIVE OR REDUCE A Y REOU REMENT OF ANY CITY ORDINANC N I ORDINANCE PROVISION. RECE, IT 0 NOR LIMIT IN ANY WAY THE CITY'l ABILITY TO ENFORCE ANY TOTAL AMOUNT DUE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIO N.THATINEINPORNi APPLICATION APPROVAL I HEREBY RIZED AGENT OF GIVEN IS CORRECT. AND THAT I AMT'Hl OWNER, oTATHE `ULYIA�T-oTiN.,CONSTFUC- EA. EUU� CALL p1 ,glld by tho� T� Pll- -1— ',j. .,l OX,,i.I 11 hil/h., D,p,ty: .d Fe- .1. P AG"EToCoM'LYWTHCITYAND, THFOWNEFL I ON WI BE EMPLOYE D T THE W..� AUTIORII THEREBY, N o PE R5NGToLL QN; 0 NO ANON G TO di 9 p.co p—,d.d FOR INSPECTION E IN VIOLATION OF THE LABOR CODE OF THE STAT OF WASH] N RELATING DATE WORKMEN INSURANCE AND RCW 1 R27, COMPENSATION OFFICIAL I NATU DATE S GNED (425) �11 c 771-0220 ELEASE Y PATE EXT 333 "o NTION TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 ITI UNLAWFUL HAS BEEN MADE AND APPROVAL OR A CERTIFI ORIGINAL FILE YELLOW - INSPECTOR ASSESSOR INAL INSPECTION OCCUPANCY HAS BEEN GRANTED: UBC SECTION 109 FAX PINK -OWNER GOLD CATE OF Z 0 c m m 0 0 80 c: rn M Z jo E: In o -n n rn im 0 Ou) 0 m ca M C) Z Z CID Z 9 0 m DATE L CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION )rEA NAMENAM�V BUSINESS .Tar,\ C17, CITY �Ip ITELEPHO E EL��mj,, �-rd NAME ICITY ZIP ITEI PHONE NAME ^N6n li-- V�-e MI ADDRESS ' -7 /1 PERMIT EXPIRES USE, PERMIT 12001191illA 'ON NUMBER I�r '08 ADDRESS SUITEIAPTO PLAT NAMEISUBDIVISION NO, LOT No LID NO. U. FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP P.— iI— EXISTING — PROPOSE. F5OUIREO DEDICATION— FT — U—g—m METER S12E LINE SIZE 10, 01 MIXTURES P V REOUIRID I 1 YES 12 NO 0 M-ARKIS—T.G— 111P.NBRILE FOR EROSION CONTROUDRAINAGE ;MOO lvwri^,e FIRE REVIEWED BY DATE C" ZIP TELEPHONE El af- Lk-7co VARIANCE OR CU SHORELINE OR ADB# INSPECTION RE. 0 YES 0 NO OND. I'S E CST L�TAYT.L NULMI�J� TE \ ��N� _ SEPA REVIEW COMPLETE EXEMPT -7IGN AREA ALLOWED F.P.�EG HEIGHT AL.ED PROPOSED PROPERTY TAX ACCOUNT FIDEL NO. GI 'ei e EXP I I I )Z�IEW RESIDE TIAL XPLUMBIN. I MECH LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PF.POSEDSEI.ACKS(FT. FRONT UPSIDE REAR) 0 AD ITON COMMERCIAL o C MPLIANCEOR CHANGE OF USE I PAR ING LOTAREA PLANNING REVIEWED BY DATE r-1 REDIODEL rl APARTMENT [:] SIGN REO'D PRO ICED I I GRADING FENCE cl REMA K' REMARKS - REPAIR REPAIR FT) X FT) _YDS X DEMOLISH TANK o OTHER c3 GARAGE CARPORT W 0 RETAINING WALL . WAL ROCKERY 0 RENEWAL (TYPEOFU , U NESS OR ACTIVITY) EXPI-AIN: CHECKED- CCVT ITYPEOICONS L�(ON"JLGJD�L-1 GRO, NUMBS NUMBEROF CRITICAL SPECIALEINSPECTOR . OFM STORIES DWELLING UNITS AREAS NUMBER REQUI R 0 YES JAREA LOAD DESCRIBE WORK TO BE DONE REMARKS IPPICTONS DFInr�FIFINIq INqPECT[ONS PER U.. I. -Ill -AL. INSPECTION REG VALUATION FEE PLAN CHECK FEE H)4PURCE GLAZING % LOT SLOPE % BUILDING DATE LAN CHECK NO: PLUMBING I-STE1 MECHANICAL -70-oo THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS IORK TO BE .. � ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL ..AN 'D.R.S. SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE m SEPARATE PERMISSION, It: STATE SURCHARGE PERMIT APPLICATI N; 18D DAYS PERMIT LIMIT.- I YEAR, PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG REVIEW FEES SEEBACK OF PINK PERMIT FOR MORE INFORMATION `G ON BEHALF OF HI OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS S ENG. INSPECTION FEE I, ;APPLICANT. 1� N NTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF 6 -nE <�- 0 0 III EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING -. - -11 --1 --- - NsIECTTON RECEIPT I FR M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT DEoEMEDT MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE o 0 NOR LIMIT IN ANY WAYTHE CITY 'S ABILITY TO ENFORCE ANY ORDINANCE PROII SION." R CEIPT TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE,NFOR.ATION APPLICATION APPROVAL GIVEN IS CORREC AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF T T ".I �, " I , I- -,l G,o- b, 1�. STAT THEOWNER. I AGREE To COMPLY WITH CITY AND E LAWS REGULATING CONSTRuc CALL .,,.zop,,pll"I 11 hll�o, DIPuly; Id FIG. .10 pIld. III TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED OF WASHINGTON RELATING TO FOR INSPECTION P-pl I, "k-I'd I Np- pl-dod, �Gd IN VIOLATION OF THE LABOR CODE OF THE STATE WORKMEN'S COMPENSATION INSURANCE AND ROW 18.27. , FC-4'A�TUR S GNr� (425) __]DATE C__ , __ I h M _ 771-0220 L ATTENTION EXT1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 P ECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI ORIGINAL FILE - YELLOW - INSPECTOR A FINAL INS CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX FINK�OWNIER - GOLD,ASSESSOR "a z 0 rn c a m 0 80 m m Z jo 0 -n n MITI 0 0 0 a T 9 co M 0 Z z z m RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ............... wall......................... z PleIPO,ch Retaining Wall ........... Slab insulation PLUMBING: rn.. Underground IT, 0 __10 Rough -in ................... 0 C Commerclal Final IT M HEATING: 10 c z -4 Gas Test .................... Gas Piping ................. Equipment ........... -4 Commercial Flnal M M EXTERIOR SHEATHING 0 fn NAILING .......................... FRAMING ........................ 0; FIRST FLOOR FRAMING INSULATION ................... Floor insulation z Wall Insulation ........... Ceiling insulation Z SHEETROCK NAILING IT SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR -C, OCCUPANCY .................. Uzi 7V PERMIT EXPIRES 7 2DATE RECEIVI,, PERMIT 2cmo �8�E CITY OF EDMONDS NUMBER OFEDMONDS 'ON PERMIT APPLICATION JOB SUITVAPT. CONSTRUCTION PERMIT APPLICATION ADDRESS 'D CID Ot, S s PLAT NAMEISUBDIVISION NO. LOT NO, LID NO, ,7,AMEINAM�IJZ LID FEE $ MAILING AD+ESS '0' PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP R CD , W(A � 5,, = Rd� d EE33 EXIS ING — PROPOSED- -' R — 0 CITY ZIP NE SW,� R,li- [3 ITILE11 10 REQUIRIDDEDICATI.— IT 9 METER SIZE LINE SIZE NO.011IXTURES PRY REQUIRED NAME YES 0 NO 0, I I h, ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE rl CITY ZIP TELEPHONE ADDRESF moo—vywc FIRE REVIEWED BY DATE CITY ZIP TELEPHONE r z -77 o Fp —ECTIO 0 VARIANCE OR CU SHORELINE OR AOB. IN N IPBOND STATE LICENSE NUMBER VXPIRATIONDATE I G 'D OSTED ES 0 UQHECKEDBY [3yRE ONO 1 P-1 HEIGHT P's �TE_5 REVIEW SIGN AREA SEPA _2�? COMPLETE ElEMPT ALL ED PROPOSED ALLOWED PROPOSED PROPERTY TAX ACCOUN I 4+ pl 1, Oni On R Oa ElP I I M LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSEDS K 8 (FT. URE7BAC RESIDENTIAL XPLIMBING I MEC ALLOWED PROPOSED FRONT SIDE REAR FRONT SIDE REAR c: 0 m 0 ADDITION COMMERCIAL o COMPLIANCEOR CHANGE OF USE —DATE 0 PARKING LOTAREA PLANNING REVIEWED By RED. C] REMODEL 0 APARTMENT C3 SIGN D I PROVIDED X M REPAIR FACING C,QR [] FENCE X FT) REMARKS M z DEMOLISH TANK o OTHER c r oGARAGE RETAKINIRNYG WALL RENEWAL ARP FT C 0 o ROO fj) 0 -n n -4 (Typ��ESS OR ACTIVITY) EXPLAIM CHECKED BY TYPE OF CONSJnU�JO < '. — i G.0 1?1� 0 NUMBEr NUMSEROF URIE'ACAL DWELLING AR 5 OF U ITS HUM E �j STORIES DESCRIBE WORK TO BE DONE 7 ��H ROE GLAZING I PLAN CHECK NO: THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO BE .. E ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC .U.... SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILLREQUIRE SEPARATE PERMISSION. RMIT APPLICATION: 180 DAYS PE PERMIT LIMIT. I YEAR PROVIDED WORK IS STARTED WITHIN 160 DAYS SEE BACK O� PINK PERMIT FOR MORE INFORMATION *APPLICANT ON BEHALF 011111 OR HER SIOUSE* HEIRS, ASSIGNS AND SUCCISORS IN NTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF I' YAND a EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENT FROM AN IF ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLSYOR INDIRECTLY E OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE FROM THEISSUANC REDUCEANY REQUIREMENT OF ANY CITY ORDINANCE DEEMEDTO MODIFY. WAIVE 0 NOR LIMIT INANYWAYTHE CITY-SABILITYTO ENFORCE ANYORDINANCE PROVISTON.' HP CIALINSPECTOR AREA EQUIRED C] YES OCCUPANI— LOAD REMARKS OGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION :RREjC`n s VALUATION FEE PLAN CHECK FEE BUILDING PLUMBING MECHANICAL GRADINGIFILL STATE SURCHARGE ENG. REVIEW FEES ENG. INSPECTION FEE BEGAP"HO INSPecmIqTE PLAN CHECK DEPOSIT TOTAL AMOUNT DUE IPT a: C m m a 0 o Fn C co c rn I M 0 Z r. X z z 9 0 m I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF Tl,i� pPIj,. .., . 11 -.1 �.p.d b' THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC, CALL B,ild,�q ol hi-1, Dlpltl: — F . p" 3nd TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOY ED IN VIOLATION OF THE LABOR CODE 0 THE STATE OF WASHINGTON RELATING TO FOR INSPECTION roceipt is acknowlodg� —p... p—idLId WORKMEN'S COMPENSATION INSURANCP AND RCW 18.27. FFICIALS SIGNATURE DATE N I GENT� S�GNED (425) CNATURE(O C I I l(m 771 -0220 LEASED By _JATE EXT/333 ATTENTION IT "UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771 _n221 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 COLD -ASSESSOR �Alll