20000938.pdfOAT' RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWN� CNAVE7ME OF BrL
e ) C R� --
MAILING ADDRESS
q,o �3 "ola a e, A�v r
CITY Z!, ITELEPHONE �1.?5
6 4LC2 -a/ -7
NAME
�PERMITEXPIRES
USE PERMIT
ZONE
!�oolzp
_NUMBER
Joe
ADDRESS
1-2� A�
SUITE/AFT�
PI -AT NAMEISUBDIVISION NO.
LOT NO
LID NO,
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
T.CPAp
�
" Zu"d
�11 U.. P.- R� d
EXISTING — PROPOSED—
1.10-
SI-11 R.qull.d
REQUIRED DEDICATION— PT —
Ug,d
WId.q.l,.d
P V REQUIRED
YE. 0 NO IJ
ADDRESS
R E
REMARKS
I
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTAOUDRAINAGE
0 W
CITY ZIP ITELEPHONE
NAME
71211Y0 -IDI-141nalk��
N
ENGINEERING
E
REVIEWEDIDATE
ADDRESS
IRE REVIEWED By
F FT.
DATE
CITY
TELEPHONE -
396
;�v ID
E'7
VARIANCE OR CU
SHORELINE OR AOBN
INSPECTION
TE
STATE LICENSE NUMBER T C111KED11
REG G
J'BONO
STE.
oo� I
SIGN AREA
OYES ONO
HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO.
SERA REVIEW
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
n, -amtj
o6so I o -0,
E X,
XP
-�TEOUIRED
,
,
NEW
Ig !RESIDENTIAL
P.LUMB GCT�M:CH
LO COVERAGE
ALLOWED PROPOSED
SETBACKS JIFE)
FRONT SIDE REAR
PROPOSED ET ACKS (FT.)
FRONT USSIDE REAR
C] ADDITION
COMMERCIAL
AN F
PL�N
0 CHANGE OF USE
�E7
P REVIEWED
REMODEL
13 APARTMENT
SIGN
fBY �GATE�
�NNING
REPAIR [3 GRADING CYOS C] FENCE
( X FT)
REMAHK5
C3 DEMOLISH 0 TANK c3 OTHER
ciGARAGE r-j RETAINING WALL RENEWAL
CARPORT ROOKERY
(T`YPE OF USEEINESS OR ACTIVITY) EXPLAIN
CHECKEDBY
I CUP
GROUPANT
jlqEl I
NUMBER
OF
0
NUMBER F
DWELLING
RITIC L
CH
A EAS
PECIALEIDN5PECTOR PANT
LOAD
.0
STORIES
UNITS
NUMBER
JAIEA
REOUIR 0 YES
JOCCU
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS
PER UBC 108/FINAL INSP FICTION REO'D
01
ff toi- ce, t1l c �E
PAP
711A6
-fro, 1791�7-iie
L?
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE
�:�=STEG
LOT SLOPE I
BUILDING
t-�,
PLAN CHECK NO:
DATE
1".
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
—
B DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADINGIFILL
W
DOE MAIN (CURBS, SIDEWALKS. DRIVE AYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
UI�)
PERMIT APPLICATI N: 111. DAYS
PERMIT LIMIT. I YEAR * PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. REVIEW FEES
ENO. INSPECTION FEE
-APPLICANT ON BEHALF 0 HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
IN INTERE T, AGREES NDEMNllY, DEFIND AND HOLD HARMLESS THE CITY UT-
ANY AND
LANDSCAPING
ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM
X ED ON &WASHINGTON. DIRECTLY OR INDIRECTLY
ALL CLAIMS FOR DAMAGESOF WHATEVER NATURE.ARISING,
INSPECTION FEE
-
RECEIPT
FR M THE ISSUANCE OF THIS PERMIT. ISSUANCE Or THI PERMIT SIAALL NOT BE
PLAN CHECK DEPOSIT
DEOEMEDT MODIFYWAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0
THE CITY'S ABI LITY TO ENFO RCE ANY ORDINANCE PROV ISION.'
RECEIPT
NOR LI MIT IN ANY WAY
TOTAL AMOUNT DUE
ou
I HEREBY ACKNOWLEDGE THAT I HAVE READTHIS APPLICATION� THAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN I CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
CITY AND STATE LAWS
s REGULATING CONSTRUC
CALL
TT,I� 00-1- '� I., IT 1 TN" ..d bV In.
THE OWNER. I AGREE TO COMPLY WITH
ll.�; AND THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE L"PLll 0
Eu,11,, 011.r.l., h,.1- D.T, ly: d F.—, P,,d. -d
% :P
IN DOING
IN VIOLATION OF THE LABOR DE OF THE STATE OF WASHINGTON RE ATING TO
Co
FOR INSPECTION
WORKMEN S COMPENSATION INSURANCE AND RCW 18,27.
(425)
;;/o
]DATE
SIGNED
///
......
I-w—
By DATY
ATTENTION
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-
ORIGINAL FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK OWNER - GOLD -ASSESSOR
�198
z
0
m
om
ca
m 0
80
c
M
m
c —Z
-4
o -n
-4
'm"
m
0
c:
c
M 0
Z
z
z
.0
:j
0
m
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
wait..........................
Pler/Porch .................
Retaining Wall ...........
0
Slab Insulatlon ..........
PLUMBING:
Underground .............
IV rn
C:
0
Rough -in ...................
0
tU
Commercial Final
M
HEATING:
Z
Im
Gas Test ............
Gas Piping .................
0
Equipment
A rn
Commercial Final
0
EXTERIOR SHEATHING
0
0
NAILING ..........................
a
FRAMING ........................
0
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
z
wall Insulation ...........
Ceiling Insulation
z
SHEETROCK NAILING
0
SPECIAL INSPECTION
M
MISCELLANEOUS ..........
F14AL APPROVAL FOR
OCCUPANCY ..................
CHECKED By TYPE CON! iTRunlo.
PA T
GROU
CT OCOU P N
SPECIAL INSPE-OR AREA OCCUPANT
LOAD
REOUIRED C] YES
A..
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
S -e Al.. A V
"A 2 -7
A
F.-I RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
ING ADDRESS
ZIP IT11EPHONE
A 4L .2 -'a.) -7 _�2
[PERMITE�XPIRES
USE PERMIT
ZONE
NUMBER
JOB SUITE/APT,
A ... SEE
PI -AT NAMEISUBDIVISION NO.
LOT NO-
N
D FEE
,�D
PUBLIC RIGHT Or WAY PER OFFICIAL STREET MAP
se- — P-h F."
EXIS ING — PROPOSED
REOUI RED DEDICATION FT
PRV REQUIRED
I YES C3 No 13
REMARKS
ADDRESS
WNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY
NAM'?R m 4
ENGINEERING REVIEWEDIDATE
ADDRESS
109 50 1A
FIRE REVIEWED BY DATE
CITY
SV&w/e 4719
TELEPHONE
-70 6 — 0.�36
VARIANCE OR CU
SHORELINE OR ADS.
INSPECTION
1_3 YRE...
IS C3 NO
BOND
POSTED
STATE LICENS NUMBER EXPIRATION DATE
CHEO'll 11
SERA REVIEW
COMPLETE I 11IMPT
EXP
SIGN AREA
ALLOWED I PROPOSED
HEIGHT
ALLOWED , PROPOSED
,OUNT PARCEL K.,
PR03 cc
L)
77— PLU.. NO I MEG"
C] ADDITION COMPLIANCE OR
CHANGE OF USE
REMODEL SIGN
E] REPAIR 0 GRADING GYQS C] PENCE ITI
C] DEMOLISH 1-1 TANK ci OTHER
GA AD
o8 E RETAINING WALL RIIE—WAL
RPORT
LOT COVERAGE
ALI..WED PROPOSED
REOU14ED SETBACKS IFT.1
FRONT SIDE REAR
PROPOSED SETBACKS I
FRONT URSIDE REARI
I
PARKING LOT AREA rNNINGIIVIEWED BY DATE
REO'D I PROVIDED
REMARKS
I i !CTQn
F. I L; Li
r
(TYPEOFUSE INESS OR ACTIVITY) EX —IN:
CHECI(EDlY
-y E STRUCtTIO
ITY' N
PANT
IFIOU
jCqEl I OCCU P
_WNIBER
OF
NUMIEROF
DW�LLING
CRITICAL
A EAS
NUMBER tJhA
TO R AREA
LOOCACOUPANT
STORIES UNI S
DESCRIBE WORK TO BE DONE �RREMARKS
PROGRESS INSPECTIONS PER �BC 108/FINAL INSPECTION
IVATi-IE -591le 1// C 6
7,le fe �)/P6'
'o lal)
PLAN CHECK FEE
ULD'No
HEAT SOURCE
LOT SLOPE %
PLUMBING
rMECHANICAL
PLAN CHECK NO:
IVESTEO DATE
THIS PERMIT AUTHORIZES ON THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTIO N ON THE PUBLIC
FANN.,F_
qRADINGIFILL
DOMAIN (CURBS, SIDEWALKS. DRIVE S, MARQUEES, ETC., WILL REQUIRE
SEPARATEWAYRMISSION.
PI MITAPPLICATION: 11111-5
PERMIT LIMIl I YEAR - PROVIDED WORK IS STARTED WITH'. I.. DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
;A PLICANT.ONBEHAL 0 HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
P
THE CITY OF
ENG, INSPECTION FEE
N INTER ST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS
EDMONDS.WASHIN TON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANYAND
ALLCILAIMS Fo 11 DA AGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
LANDSCAPING
INSPECTION FEE
FROM THE ISSUA CE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINAN E
3 NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
TOTAL AMOUNT DUE
I HEREBY ACKNOW EDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
T E OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGUI-ATING CONSTRUC-
TION; AND,IN DO NO THE WORK AUTHORIZED THE REBY, NO FE RSON WILL BE EMPLOYED
CALL
r
IN VICLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING 10
0 TI,
FOR INSPECTII
WORKMEN'S COMPENSATION INSURANCE AND RCW IB.27.
BIG LIFE OWNER o DATE SIGNED
(425)
C.)
—0220
7 1_0 0
71
ATTENTION
EXT 333
ITIS UNLAVVPULTO USE OR OCCUPYA. 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
FAX
VALUATION I FEE
"T
APP icAmON APPROVAL
Thil pplh�hs not a polmh 11 sig.ed by the
BORdi.9 Olhdel th Deputy: hd Fee. — bed. hd
"""o V oq.d h P.. P—ld.d.
-FIGIA VIG.A ATl
It _/o 0
00
ORIGINAL FILE YELLOW - INSPECTOR
PINK -OWNER GOLD -ASSESSOR
Z
0
m
m 0 m
0
80
c
5� m
m m
z
10
0 -n
m Ill
0
o Fn
C cn
c (1) 1 1
TO
X
z
-4
X
V)
z
0
0
m
7- -------
elly. TIE RECEIVED
-DO
=OFPERMIT EXPIRES
CITY OF EDMONDS �ONE
9"s-s
PERMIT
20CS?Se
CONSTRUCTION PERMIT APPLICATION JOB
ION
-NUMBER
SUITEiAPTN
ADDRESS io o -i
--? S' -
4,-- L�)_
OWNER NAMUNAME OF BUSINESS
1t14 4 7741,4�4—'
PLAT NAMEISUDDIVISION NO.
I LOT 110,
U NO -
LID FEE $
MAIUNGADOR BE
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
W, d E3
P1111111d 0
A 3b,145
EXISTING - PROPOSED
U.. P_ AKd 0
CITY ZIP
11ELEP..N!E
REOUIREDDEDICATION-
-,,,E
FT
0
NAME
�ETER
R MARKS
RRV REQUIRED
YES 0 NO 13
ADDRESS
CITY ZIP ITEU11HONE,._
NAME
Novice'/
ADDRESS
CITY ZIP
LysfAaladl "/,4
ELE'"I
STATE LICENSE NUMBER
)V/; 0 v /1'L/ ri-e) 3 3 4) 0
EXPIRATION DATE
51(.)l
KEDBY
1
PROPERTY TAX ACCOUNT PARCEL NO.
00
0 NEW
PLUMBING I MECH
AUDITION
Ei C MPLIANCE OR
CHANGE OF USE
REMODEL
SIG.
REPAIR GRACING CYOS C] FENCE
( X FT)
DEMOLISH 0 TANK
0a'ER
C] GARAGE RETAINING WALL
CARPORT Rnr.KFRY
RENEWAL
DWELLING PEAS
STORIES
UNITS
NUMBER
DESCRIBE WORK TO BE ..N!_'�
L/
31 I-F
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
FIRE REVIEWED By DATE
VARIANCEORCU
SHORELINE OR ADS#
INSPECTION
REO'D
I BOND
POSTEC
[3YES (3 No
I
SERA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
EXP I
I
,
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (M.
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UPSIDE REAR
PARKING
LOT AREA
I PLANNING REVIEWED By DATE
REDD I PROVIDED I
CHECKEDBY ITYP
SPECIAL INISPECTOF
REQUIRED [:] YES
REMARKS
INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
LA 1J. I
VALUATION FEE
PLAN CHECK FEE
GLAZING % LOT SLOPE %
BUILDING
PLAN CHECK NO: 11EST11 DATE
PLUMBI G
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE W.R. NOTED. THIS PERMIT COVERS WORK TO
�j BE 00 N PRIVATE PROPERTY ONLY. ANY I...ST...10. ON THE PUBLIC
RAD11.'FILL
.OMAI�1(0
2 CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 10D DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. INSP50TION FEE
'AP LICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
P
HARMLESS THE CITY OF
Na
I
IN NTEREST. AGREES TO NDEMNIFY. DEFEND AND HOLD
I"
EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
A
IbISP.11Q�ON FEE
ALL CLAIMS FOR DAMAGES OFWHATEVER NATURE, ARISING DIR,_1 . L
R CEIPT
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMCDT MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0
A ISION�
PLAN CHECK DEPOSIT
. NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE
0
TOTAL AMOUNT DUE
2,
I HEREBY ACKNOWLEDGE THAT I HAVE R�AO THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
Thil IPP11-1- I' "I I .,I uIIII.Iolld by 1h,
THE OWNER. I REE To COMPLY WIT. CITY AND STATE LAWS REGULATING CONSTRUC
AG
CALL
Bu,Id 1. IVI, D.Ppu,y: ..� F... .1. I.id.
P
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, No PERSON WILL BE EM LOYED
OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
IN VIOLATION OF THE LABOR CODE
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
F ILS IGNAW�,, DATE
qT)
(425)
- . I - I A AC;) -A 1")
771-0220
Ell �DEI DATE
ATTENTION
EXT1333
J/1 1 1-1
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
CATE OF OCCLI'ANO Y HAS BEEN GRANTED. UBC SECTION 109
FAX
IINK-OWNE. GOLD-ASSESSO.
5198
z
0
Ri
0 m
c
mo
0
80
a
m m
ca
0
'T1
m M
0
o -m
C a)
7-1
;a
-4
z
z
9
0
m