20000919.pdfRMIT EXPIRES 5- 15101
PERMIT
l!)
ZONE K — .1
CITY OF EDMONDS NUMBER
CONSTRUCTION PERMIT APPLICATION joB
ADDRESS
OWNER MIMIMAME 01 lUSINEs
PIUNT NAME;SUBDIWSION NO. LOT NO, LID NO, 0
_�fjn�u t t-,16- C> 41D FEE s
MAILING ADDRESS PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
U.. oo
EMS tmG- PROPOSED- ....... o
CITY zip 1-
ITELEPHONE
oeo4U 4zr, -M-:1 - OL03 REQUIRED DEMCATION� FT a
.ETES SIZE LINE SIZE No, 01 FIXTURES PRV REOUtRED
NAMIA.V YES 0 NO 0
I
REMARKS
s .-PONSIBLE FOR EROSION GONTROUDRAINAGE
Z
ate--1 fo>_�v &Lt-6 y
ZIP TELEPHONE
REViEWEDtDATE
ENGINEERING
ricx� DATE/
Fl vi
C,T zip TELEPHONE
c �p
Q 'C�clott, ��
I � CHECKE By u SHORELINE OR ADB# POSTED
Q
o,REQ
STATE LICENSE NUMBER --l-11
NO
ES HEIGHT
aaTv_-k
SERA REVIEW
COMPLETE EXEMPT ALLDVBD PROPOSED ALLOWED PROPOSED.
;I PROPE]�T PgLNO.
I
up I I
RE.UIR PROPOSE SETBACKSHFT)
LOT COVERAGE ED SETBACKS
F UR SIDE REAR
FRONT BID REA�V FRONT B
NEW C] RESIDENTIAL ALLOWED PROPOSED
Cj C MPLIANGE OR
0 ADDITION 0 COMMERCIAL co
RANGE OF USE
Z
PARKING L
REMODEL APARTMENT C] SIGN REQ'D I PROVIDED
0 REPAIR GRADING CYCE M '11HCE X IT) REMARKS
DEMOLISH TANK 0 OTHER
GARAGE 0 FIlTA'lING WALL RENEWAL
CARPORT R..K.R, C3
WITY) EXNIN: CUPAN
ITYPE OF USE, BUSINES BECKET) By 0 CONSTRUCTION c E Roup
r
NUMBER NUMBER OF CRITICAL 71 OCCUPANT
'WELLING A EAS SPECIAL INSPECTOR AREA LOAD
OF R
STORIES UNITS NUMBE REQUIRED 0 YES
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
2
_%'lloo
k,3L, c)
L
VALLI ]ON
FEE
PLAN CHECK FEE
HEAT SOURCE "A", LOT SLOPE % BUILDING 0
PLAN C 0: PLUMBING
W5�� J I ED DATE
�%� -mr ECHAMCAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT CO
ON THE PUBLIC
BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION GRADINGIFILL
DOMAIN (CURBS. IIDEW41 Kq. DRIVEWAYS ETC,) WILL REQUIRE
SEPARATE PER�,MAROUEES,
F. SSION. STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
WITHIN 180 DAYS Z_ZEW FEES 0.
PERMIT LIMIT. 1 YEAR, PROVIDED WORK IS STARTED
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG, INSPECTION FEE
SIGNS AND SUCCESORS
'APPLICANT ON BEHALF OF HIS OR HER SPOUSE� HEIRS, AS ARMLESS THE CITY OF O'D
D AND HOLD H
IN MNgE .. W .. E,, TO NTE.NilY, 111PEN
S. ABFB.T.N,;Tr , CIALS, EMPLOY ES, AND AGENTS FROM ANY AND
ED �. F,
ATE E
A CLAIMSFORDAMAGESOFWH v R NATURE, ARISING DIRECTLY OR INDIRECTLY RE PT
LL
OF THIS PERMIT SHALL NOT BE CHECK DEPOSIT
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE PLAN
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT 05 ANY CITY ORDINANG
NOR LIM[ WAYTHE CITY'S ABILITY To ENFORCE ANY ORDINANCE PROVISION. RECEIPT
0 TINANY TOTAL AMOUNT BUC
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION APPLICATION APPROVAL
GIVEN I I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF T'-pplk 1-1. P-1, -1, Pa- b,
CORRECT, AND THAT LL
TO COMPLY WITH CITY AND STATE LAWS REGULATING CON$TSUC .�d F - ,J. �d
CA o
,E . I AGREE B,ij
THE oWS A
TON: AFI, IN DOING THE WORK AUTHORIZED THE REBY, NO PERSON WILL BE EMPLOYED R INSPECTION facupi is a-t�dpd.. IIP P-1-
OF WASHINGTON RELATING TO FO
IN VIOLATION 01 THE LABOR CODE OF THE STATE
WOFIKMIN'S COMPENSATION INSURANCE AND FCW 11121. = sA
(425) zE
SIGNATURE (I _(_ i
ITE S�GNI�A
AJ
L
_)D
Vk 771-0220 RELEA�Eb BY
_w_.W_W�A
EXT 333 A
ATTENTION -k -�o I', f;
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-ORIGINAL - FILE - YELLOW - INSPECTOR
- ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 FAX PINK - OWNER - GOLD
5198
Z
11 rn
,o
0 oc
mm
F4
O.n
_n
m M
Or
o-,,
mo
Z
0)
Z
m
, m
Go of ebmonbl
0
(Certiti tt"antr
DEpAgTMONT OF IWUILDINGP%�,
UNIF01111M OU11,011" 0;:�
No. Stodos; 2
4 Hr Spirl Basement: No
RIM
occupancy astablIshed by this C4 Icate: Dwellin UnIft:
A 1. B C. 1002)
"Imum
ul
ar
owner df BuIldins: H THE REQUIREMENTS OF THE
THE n Ir C dot 8 C ND DIVISIO OF OCCUPANCY AND THE USE
I DITION OF THE.UNIFORM Wili
uA
F R WHICH THE PROPOSED OCCUPANCY IS
2001
issued this
C
BY.,
Thl.cafflop,04,hal be *IW Ing ptuoue public am* and.hall nctlue —ad, inuflated crobiwaned and be balotlinal In legible condition at.11 obr-
Cacti or occubancy haboid by line City of E4.." Building 01i
a
ZT
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ................
FOUNDATION!
Footing ......................
Wall ..........................
Pier/Porch ... ..............
Retaining Wall ...........
0�_
q
Slab insulation ..........
M
PLUMBING:
Underground .............
13 M
M,
1, r "
Rough -in .................
IS
-10'
j
Commercial Final
0 a
M
HEATINGz
M
Gas Test
Z
Gas Piping ................
x
Equipment ..................
Commercial Final
n
EXTERIOR SHEATHING
M M
NAILING ..........................
0
FRAMING .............
FIRST FLOOR FRAMING
ITI 0
LR
INSULATION .................
Floor Insulation
Wall Insulation
z
Ceiling Insulation
C9
Z;
SHEETROCK NAILING
SPECIAL INSPECTION
Or
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR �e
OCCUPANCY .............. 2- _2&Z
f/f
I E
x PERMITEXPIRES
PERMIT
CITY OF EDMONDS a q NUMBER
CONSTRUCTION PERMIT APPLICATION T�
�u-, -47-ok A
I CITY IT61S IONE
...... iqz-7 Fvw 6."'e y
ATY III TEIS111.1E
4se,�,.t-TL'Ig
9AME-F
4,1 r
__t
ADDRESS
Akr CA� 5C�QE_ Ct?,U_,2
T111PHON
STATE LICENSE NUM ES
i v-pascoc_�:,
PROPER UNT
PARCEL NO.
—
q(NEW
W NW�
0 ADDITION
COMPLIANCE OR
CHANGE OF USE
C] REMODEL
0 SIGN
0 REPAIR
C3 GRADING CYDS
FENCE
Fl I _X_',
0 DEMOLISH
C3 TANK
o OTHER
J
BE
0 OCA'�RIAORT
RETAINING WALL
El FOCKRy_
RENEWAL
0.1
',TyPEOF USE, BOSINGES QaWJIVITY) FXWINt
OF DW LUNG
STORIES �
I UNITS
DESCRIBE WORK TO BE DONE
T�__x-rIL _�_
I (z)
PLAT NAME/SUBDIVISION NO�
LOT NO,
LID NO,,
LID FEE
"7111 IG RIGHT OF WAY PER OFFICIAL STREET MAP
T InAll—a 0
RIVI = 111.1,
EXISTING — PROPOSED .
..... 11 ..... do
Va.-J, .10 0
REQUIRED DEDICATION— FT
=11-111.
YEPR-U'R'D
DV No 0
=.A=S.slll APAP—RIBUS FOR EROSION CONTROUDRAINAGE
E
I
as
: I
z
TIAMANC� OR GO
SHORELINE OR ADBs
INSSEEOCTION
0
PBONO
OS
OYES ONO
0
SERA REV' 'W
SIGN AREA
PROPOSED
HEIGHT
ALLOWED PR POSED
,0.,LE,S ..FT
C
ALLOWED
I
,
LOT COVERAGE
REQUIRED SETBACKS (Fn
PROPOSED SETBACKS (FT)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UP SIDE REAR
ILOT
as
yl
M
M a
PARKING
AR�j
PLANNINgG REVIEW-1)
By DATE
I E'T
REDD I PROVIDED
0
(50
c
M
In z
j01
c
0-
,TOR JAREA
YES
MITI
INSPECTIONS PER UBC 108/FINAL INSPECTION REDID
5
j
as
0
0
M 0
>
VALUATION
FEE
z
PLAN CHECK FEE
LOT SLOPE %
8 ILDING
nn
z
PLAN CHECK NO:
VISTIO DATE
PLUMBING
MECHANICA
0
M
OTED S EAMIT COVERS WORK TO
THIS PERMIT AUTHORIZES ONLY THE WOLRYK NN
BE DONE ON PRIVATE PROPERTY ON . A Y C6NTHRUCTION ON T
`REUBLR'�
GRADINGiFILL
DOMAIN 'COPIES SIIEWA S, MARQUEES, ETC.) WIL" �QU, E
LKS, DRIVEWAYMISSION. L
L
SEPARATE PER
STATE SURCHARGE
1. RMIT APPLICATION: 180 DAYS
A.
0 180 DAYS
PERMIT LIMIT: 1 YEAPR� PROVIDED W RK IS STARTED WITHIN
REVIEW FEES
SEE BACK 0, PINK PERMIT FOR MORE INFORMATION
ASSIGNS AND SUCCESORS
0 -APPUCANT ON BEHALF 15F HIS OR HER SPOUS5� HEIRS. -A-, THE CITY
DEFEND AN. .,G)H
ENG. INSPECTION FEE
PING
'3
IN' R - EN, IS . S 0 SOF" L EMPLOYEES AN A. NTSFROM ANYANOOF
AGI E N.EMNIFY�
M`.TE.VWA N TONI :T CIA E� �MUISS
4NSP t�%c
"'c—
ED .
as AULCLAIMSFORDAMAGESOFWHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY
SHALL NOT BE
SEC PT
FROM THE ISSUANCE OF THIS PERIAll ISSUANCE OF THIS PERMIT
C TY ORDINANCE
I
PLAN CHECK DEPOSIT
REDUCE ANY RSOUIREMENTOF
DEEMED TO MODIFYWAIVEOR ORANY
CITY'$ ABILITY TO ENFORCE ANY DINANCE PSOVISION.�
REC 'T
NOR LIMIT IN ANY WAYTHE
TOTAL AMOUNT DUE
iv,0(4
THAT HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
APPROVAL
I HERE Y ACKNOWLEDGE
0 R
� OWNER R THE DULY AUTHO IZE AGENTOF
GIVENS CORRECTANOTHAT AMTHE
'�PALL
p.najtuajiI.I,a.dbyIa-
CONSTRUC-
THE OWSSR. I AGREE TO COMPLY WITH CITY AN6 STATE LAWS RE.UTNGO
'hi=D puty:aad Foos am pad, and
NO PERS N WILL BE EMPLOYED
TION: AND IN DOING THE WORK AUTHORIZED THEREBY. 0
TO
INSPECTION
m,dipt I, dckn,,Iodgod o.P-Aq P—ldia!
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHI NGTON RELATING
18,27.
SIG ORE 9 TE
WORKMSN'S COMPENSATION INSURANCE AND RCW
(425)
OFF[
SIGNATURE (OWNER OR A
DATE SIGNEa
I
771-0220
RCL 0 0 E
ATTENTION �_Le
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
PPROVAL OR A CERTIFI- 771-0221 ORIGINAL � FILE YELLOW, INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND A 0
FAX PINK -OWNER GOL -ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTI . ON 109
5198