20000915.pdf04TE TRECEIVE0
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
0)
CITY ZI JTELIIFO�E
-u4) q , - ��/J,. 6�
Oil wu
NAIVE
[PERMIT EXPIRES
UA PERMIT a'00315
ZONE NUMBER
JOB A i SUITEIA-
ADDRESS
PI -AT NAMESUBDIVISION NO. LOT NO. LID NO.
LID FEE S
ETES-Appi-
PUBLIC FIGHT OF WAY PER .111CIAL STREET MAP P.,
P'll
U.: P1111
'"d
EXIS ING — PROPOSED- 0
SW11
REOUIRED DEDICATION— FT —
FRY RE.UIRED
:!!!!!!:=lIXTUFlS
YES 0 NO
REMARKS
OWNSHICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY ZIP I I
NA E
EMDATE
ADDRESS
FIRE REVIEWED BY DATE
CITY
0
OR ADS. INSPECTION BOND
STATE LICENSE NUMBER
VARIANCE OR CU SHORELINE
RE, 'D POSTED
YES ONO I
uid maof It/
ol� g 11 1 !zd
SERA REVIEW SIGN AREA HEIGH T
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED P ROPOSED
PROPERTY TAX ACCOUNT PARCEL NO.
I I I
&I l//l? -A,") 2�__
A9 �glaQ - A
'Xp
- I
LOT COVERAGE Re 11-RED SETBACKS IFT) PROPOSED SETBACKS (FT)
FRONT SIDE FEAR FRONT UREME FEAR
0 NEW 0-.E.I.ENTAL
PLUMBING I VIE..
A-.VVED PROPOSED
COMMERCIAL
COMPLIANCE OR
ADDITION
CHANGE OF USE
PLANNING REVIEWED By DATE
REMODEL APARTMENT
SIGN
REO'D I PROVIDED
C] REPAIR GRADING CYDS
E] FENCE
X FT)
EMAHNN
DEMOLISH TANK
Ei OTHER
GARAGE C] ETAiNING WALL
CARPORT �Rjo C FR
RENEWAL
J3
_�TYPE OF —USE, BUSINESS OR ACTIVI��XPI_AIN
c P
CHECK PE PAN
T' 771-
Ty "M
ED ']--(AREA
_—TOREA
NUMBER NUMSER OF
R TIC AL
PECL" N CTOR
-L.-.-
OF ELLNG
S
B R
L� S
REOUIFEI�n lE
0 YES I
o STORIES u
NU.
DESCR15E WORK TO BE DONE
REMARKS
ROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO
Regardiess of whathor the water syste M
PLAN CHECK FEE
A SOURCE GLAZING I LOT SLOPE
BUILDING
PLAN CHECK NO: VESTED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHO IIES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
L BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
OR ', 311ILL
. DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC) WILL REOIRE
:I SEPARATE PERMISSION.
FICHARGE
2 IE MIT APPUCATIO-w - DAYS
R
1. PERMIT LIMIT. I YEAR PROVIDED WORK IS STARTED WITHIN IllbDAYS
ENG VIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
APP`C'N`j.DAN.B'EHEA" ` )F HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
NIFY. DE5ENo AND HOLDHARMLESS THE CITY OF
END INSPECTION FEE
ANDSCAPING
I.NEFES . ST. INDEM
WASHINGTON TS,,,,,,ALl.E.PL.YEEl,�N AGENTSFROM ANYAND
INSPECTION FEE
EDMONDS.
AGESo'WHAT R NATBRE E DIRECTLY
ALL CLAIMS FOR DAM . ARISING DIR CTLY OR INDIRECTLY
ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DFPOSIT
RECEIPT
FROM THE ISSUA CE OF THIS PERMIT.
DEEMED TO MODIFY, WAIVE OR RED CEAN RED IREMENT OF AN' CITY ORDINANCE
U Y U
PFDVIbILN
HE Elp
NOR LIMIT M ANY WAYTHE CITY S ABIUTYTo ENFORCE ANYORDINANCE
TOTAL AMOUNT DUE
APPLICATI THAT THE INFORMATION
APPLICATION APPROVAL
LEDGE T DON,
1 HEREBY ACKNOW HAT I HAVE READ THIS
GIVEN IS CORRECT. AND THAT I AM TIE OWNER OR THE UL, AUTHORIZED AGENT OF
Thl� PPI-1- 'b P-I b 1,.1 -1,1 �lglld by thl
THEOWNER IAGREETO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRLC
WILL BE EMPLOYED
CALL
Bu.,,g o,, ., I,j, D.%. y , F .,. , �I,d
TION. AND IN DOING THE W No PERSON
0 AUTHORIZED THER.EBY6. FEATI To
WASHINGTON NG
b�d
,,,.Pt.,.ckn..Ildgb P p
FOR I NSPECTION
IN ViOLATI N OF A LAB R CODE OF THE STA E
WORKMENos CoMPTE, �Aq.J�NSURANCE AND RCW 18.27.
ICIALS 51 ATURE ]ATE
SIGNATURE (01? 1 TE SIGNED
(425)
// -,/ / 0
771-0220
DATE
FILEASED-Y
tEtL
EXT1333
ATTENTION
USE OR OCCUPY ASUILDING OR STRUCTURE UNTIL
771-0221
IT IS UNLAWFULTO
OR A CERTIFI-
ORIGINAL FILE YELLOW - INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
- B
FAX
PINK - OWNER GOLD - ASSESSOR
z
m
c: M
0
80
c
-4
A
z
c
0
"n
-4
2:
m A
0
c TO
r. (j) ,
M 0
Z
.I�
;13
Z
-4
ch
z
9
0
m
Renaming . ... ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ..........
Commercial Final
HEATING:
Gas Test .......... .
Gas Piping ...........
Equipment .... ............
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING
FRAMING_
INSULATIRN
r ulation
F oo''Ins
Wall insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
APPROVAL FOR
FINAL
OCCUPANCY ..................
loy 00000'
q
cc)
ITIO
C
M z
ID -1
C
0 _n
_n
mT -V�
ow:
0
0 r,
C to -je
0,
z
z
M
.. .. ... ...
DATE REqFiVED
7 7,1
%J FPERMIT EXPIRES
zx
Z.SE
PERMIT aoCal.5 77
C OFEDMONDS
ITY
NE
NUMBER
CONSTRUCTION PERMIT APPLICATION 'AODODRESS
�g
SUIT11AIT,
,07� NAMENAME OF IUSIN SS
A�jj
I PLAT NAMEISUBDIVISION NO.
IOT"O, L�DN
llu
D FELS
0
PUBLIC RIGHT OF WAY PER OIRCIAl STREET MAP AW�' SV.d 0
-.1 U.. P.- ..0 0
C, I ZIP TELEPHONE
1XISTING - PROPOSED
0
0
REQUIRED DEDICATION-
FT (3
PRV REQUIRED
NAME
YES Cl NO 0 9
ADD�ESS
lAw
l'und
Avy Pic
DATE
CITY
Zp
I
TELEPHONE
FIRE REVIEWED BY
SHORELINE OR ADBN
STATE LICENSE NUMBER
DATE C EOKED BY
VARIANCE OR CU
L
C]YES 0 NO
HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO.
SEPA REVIEW SIGN AREA
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PRO10 I D
xAgN
9 - l
EXP , I
NEW
PLUNIMN. I
LOT COVERAGE REOUIREDSETBA.KSIFTl PROPOIEDSETIACKSIFT.)
ALLOWED PROPOSED I ... T SIDE REAR FRONT LIREME REAR
ADDITION
OR
C MPLIANCEOR
Co M P
0, USE
CHANGE OF USE
H A N
LOT A DATE
PARKING L.TAREA
REMODEL
6,
0 SIGN
ON
JILANNINGIIVIMEDIY�
Q.
RE D I PROVIDED
0 REPAIR
FENCE
FENCE
0 GRADING CYOS 0 X FT)
X
I X
I _
M - S
EMARKE
RE A
E] DEMOLISH
0 TANK
OTHER
OTHER
0 GARAGE
CARPORT
dANCE
M RETAININGWALL W L
I__` ROCKERY RENEWAL
;K
(TYPE OF USE. BUSINESS OR ACTIV
C
R..
CHEIKElly ITYPEO121TRUCTI CCUPA�,
V/m 7
NUMBER
_FN ER
UNTO
I TIC L
RTCAL
OAREAE
ov,
BE Al. A�EA -2
OF
C STORIES
-EL, NG'
U.7
T.
E
M.ER
NUMB R
RE IRE
DESCRIBE WORK
TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 1081FINAL I
rpmag I mAit e
wa M J, ho
or gosea. smansion
Oin all hbt waw tAmm
GLAZING % LOT SLOPE I
PLAN CAECK NO: IVE5TED DATE
o.
B PERMIT C-V .. W K T
THIS PERMIT AUTHORIZES 0 LY THE WORK NOTED. THIS PERMIT COVERS WORK TO
".. 'T'.N ..... U-L 'C
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN tCUEBS� - E. ETC I WILL RE. -IRS
zi SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PLAN CHECK FEE
P LA N CH,
IN ECK FEE
BUILDING
8 I'D
PLUMBING
MECHANICAL
OR INGIFILI
GE
VC
PERMIT APPLICATI H; 180 DAYS
WITHIN I BIT -A
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAY
ENG VIEW FEES
.. AT'o.
PINK PERMIT FPITIMORE I�FORMATK`N_
AND SUCCESORS
AS.K` NS AN D EU.-E
'APPLICANT. ON BE AL IS OFI HER SPOUSE. HEIRS. A
H
ENG. INSPECTION FEE
NIFY. DEFEND AND HOLDSHSIGNS
I Y
D AR.L"-S THE C T
INDEM ARMLESS THE CITY Ul
IN INTEREST AGREES FIGF
LANDSC,IPING
AN.
ANYAND
NO �G N PC ANY
E TBE -
2 EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM
INSPECTION FEE
RE TLYo DIRE TLY
FIN
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
R
P
THIS PERMIT "ALL No T BE
I FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT sHALL NOT BE
0 ENT OF ANY CITY . RDINA N
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
....... ...
TOTAL AMCUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT TH E INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITYAND STATE LAWS REGULATING CONSTRUC-
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE CNIPLOYTED
IN VIOLATION FPT ABT ODE OF THE STATE OF WASHINGTON RELATING 0
'S CoM SURANCE AND RCW 18.27,
WORKMEN EI�A.p. �NC
FOR INSPECTION
StGNATURE,(]M_ GAT
(425)
md
771-0220
ATTENTION
EXT1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
z
0
m
Co
m
0
80
C
m
m z
jo-4
9z
0
m M
0
0 F,
C co
%;. In
M 0
Z r,
z
z
0
m
APPLICATION APPROVAL
TN. Ppli-l- m 1 . P.` ,IK p.d b, Ih.
'U'�, Offid.1 r hl,lh.r D.,I, ,d F - Pa,d. -d
,.-pl m .�01.dgod !� 1p- -d-
�ICIALS SI 11
ELEASED BY DATE
OnIGINAL-FILE - YELLOW INSPE
G _ E .
PINK -OWNER - OLD AS EBB
. D