20010547.pdfDATE "'C"IM-4 196t
FPERMIT EXPIRES lw, 0-a-
USE PERMIT
24 e
CITY OF EDMONDS 2;� NUMBER
CONSTRUCTION PERMIT APPLICATION JOB SUITE/AFT#
ADDRESS e
OWIIIY.IA;71r _W 90N Ll�l
PLAT NAMEISUBDIVISI NO I LOT NO, LID NO,
LID FEE S
MAILING ADDRESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 0
<;-,;t 7 Ul. P.I....
EXISTING — PROPOSED -
CITY TELEPHONE
_6 M REQUIRED DEDICATI N_ FT
'NAM OF FIXTURES Y,:RV RED I
0 NO,
REwMl`PR`%NTAACTOA RESPONSIBLE FOR EROSION CONTROUDRAIN
m
8
ADDRESS
-755 6 12WAO
m 00
r
M
FIRE REVIEWED By OAT
Cl u oe_61�, ,,jlEUEP"llE
%p lf4p �l
VAII14��:RCU
SHORELINE OR ADO#
INSRPEECC!ION
0
OYES bjNO
I BOND
STATE LIC Wd. ER EXPIRA"[14
0
WT T,
DATE
CH Y
SEIA REVIEW
EXEMPT
EXP
SIGN AR4A
ALLOWED , PROPOSED
HEIGHT
A ULOWED I PROPOSED
PH I PARCEL NO.
NEW RESIDENTIAL �<P.LU.. I M...
C PL�AN EOR
COMMERCIAL C
)<AUDITION 0 CHANGE OF USE
REMODEL APARTMENT SIGN
0 FENCE
REPAIR FIADINO CYOS X — FT)
DEMOLISH 0 TANK
X
LOT COVERAGE
ALL OWED P
tgo R��;j
REILM111111AC11111
FRONT SIDE HEAR,
ao, J�),
PROPOSEDISETIBACKS11T.1
FRONT SI E,
al
PARKI
REDD I P �IDED �'T
EWEOaY
wMs
0 GARAGE r-1 RETAINIMOlk— RENEWAL
CARPORT _ ._.F. 0
0
IS
r
(TYPE "SUSIN SO, R A EXPLAIN:
CHECKEDBY
ITYPEO
jyCyION
GROUP
IC771 OCCUPANT4 3
m M
0 as
NUMBER 0 F ��CRITAICALCA
OF WELLING
STORIES UNITS
NRE S
U BE�R
SPECIALINSPE
REQUIRED
NT
DES RIB BE ME
-4— t_L401,17
REMARKS
PROGRESS INSPECTIONS PER UBC 108tFINAL INSPECTION REO'D a
I -I
Aa, &_tIe
P., ,
LA32M-_t__�
PC*-
c"a)
Z
z
PLAN CHECK FEE
VALUATION
I(IE
?AT
jjLo,&p
PLAN CHECpO: VESTED DATE
/
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
L 1111"1 ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
RIVEWAYS R UEES. ETC.) WILL REQUIRE
.MAIN ICURBS. SIDEWALKS, n PER�IMA 0
SEPARATE SSION.
t: -
BUILDING
PLUMBING
MECHANICAL
GRADINGfFILL
R CHA R E
STATE SURCHARGE
'T AT U
-7
.0-1
5
PERMIT APP.C.11 N: 1.1) GAYS
PERMIT LIMIT: I YEAR ROVQEO WORK IS STARTED WITHIN 160 DAYS
P
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
so R'
'A PLICAN NBEHAL F HIS OR HER SPOUSE. HEIRS. ASSIGNS AM. SUCCESORS
F
IN NTERES . AGREE To INDEMNIF V DEFEND AND HOLD HARMLESS THE CITY OF
21 EDMONDS, ASHI T N. ITSOFFICIALS, EMPLOYEES. AND AGENTS FROM ANYAND
�'Y
Y AN
2 E-T L.
ALLCLAIMS FOR DAMAGES OFWHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY
.T
m FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SMALL NOT BE
N C E
'MAN E
0 C
DEEMED TO MODIFY. WAIVE OR REDU E ANY REOUIREMENTOFANYCITYORDIMAN E
'.BID
2 NORLIMIT INANYWAY THE CITY'SABILITYTO ENFORCE ANY ORDINANCE PROVISION.'
0
EV EW E
ENG. REVIEW FEES
EN G
Sp '0 N FEE
ENO. INSPECTION FEE
'No ECT
-E G S
Ap IN
LANDSCAPING
LAND S
NS FEN I N
c
PLA '
CK DEPOSIT
PLAN CHECK DEPOSIT
N E
'E
CUNT DUE
TOTAL AMOUNT DUE
TOTAL A.
RECIIB��
R �1� 50
CEIY.7,�Y_
IR
WAT ON
PPL,CAT,ON THAT T"E'NFORMATI..
I HEREBY ACKNOWLEDGE THAT I HAVE HEAD THIS A H,.E..L AUTHORIZED A 3ENT
GIVEN IS CORRECT. AND THAT I AM THE OWNER. C GENT OF
T EOWNEFI� I AGREE TO COMPLY WIT. CITY AND STATE LAWS REGULATING .NSTRUC.
H A OY
TION AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOY ED
ATI
I N VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON REL TING TO
WORKMENSC2yRkNSATIO INSU AN 7
APPLICATION APPROVAL
CALL Th III.IPP1.1.111— 11
ALL dII, III. I., put,dF.....PIIdd
FOR INSPECTION oceipt.s acknow1�1god—p— p,ov,ded.
Sp TIC
( 5) Off[Al �S SIGN�ATURE DATIJ
(425)
CtUkia, &W,
1 0 0
17171 DATE I
_W22m REL7D By
,tATTENTION
EXT 1333
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 FAX
PINK - OWNER - GOLD - ASSESSOR
SIB
a
Ld
u
w
ll�
OW
eL.lo
6 ATrA eo-A 4
ry)
;c�-Jd gy
7�11
�,X 12-75
E�
ACCEPTABLE TIGHTLINE
MATERIAL
SDR 35
SCH 40
N -12
F8`10 HANCOR
4
t07,
&W OR
�y
tt
xffs
T. SYST.
PD
w-mr F�L 100,0 OR
AS NOTED'
By -
EN NEFRING
uj
A, L, IJ Li -r -r
LU
co
MICROFILM
c,
m i
c: I
m
mm
T
0
0 Fn
cg
rn
. . ........ .
. . .... ....
THE LAND REFERRED TO HEREIN IS SITLJATED IN THE STATE OF
WASHINGTON, COUNTY OF SNOHOMISH AND IS DESCRIBED AS FOLLOWS:
Lots 30 and 31, Block 74, The City of Edmonds, as per plat recorded in Volume 2 of Plats,
page 39, records of Snohomish County, Washington.
Situate in the County of Snohon-dsh, State of Washington.
RECEIVEI)
JUN 2 2 2001
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
FINAL PROJECT APPROVAL FQRTq
TO:-
DATE: —
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTNIENT DATE —
ENGINEERING DIVISION DATEJL�
PLANNING DIVISION DATE —
PROM
SITE ADDRESS 1AMijul- S-L
PERMIT
____PATE INSPECTED
_�ADB#
DESCRIPTION OF WORK TO BE INSPECTFD—EALAK-L----�
n was conducted to determine final compliance with approved plans. Finak approval
A field inspectio
above signed Department to the release of
denotes that there are no objections from the
PERFORMANCE BONDS and the granting of:
V---�GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy ofCONDITIONS given to owner/contractor by inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inspector
1.
2. MICOMFILM
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date. Sigu�
ocaprvl.doc.l:teap:bldg:formsIO/OI
z
0
i
0
0 M
C 0
M 0
o --'2
--I K
X M
M Z
10-4
z
-4
o -n
--I
M:
M M
a
0
0
Cn
M 0
Z
z
U)
z
0
4
0
M
co
DATE RECEIVED
FP"NIT
E4PIRES
PERMITA
NUMBER
ZONE
CITY OF EDMONDS
APPLICATION 'AOURESS
SUITTEIAPTI
CONSTRUCTION PERMIT
�:g
�O 0
OWNEYA111JIV�MEr 1�
EE s
... CP APp— 0
P BLIC RIGHT OF WAY PER OFFICIAL STREET MAP R 0 0
ml MAILING ADDRESS
0a) t
mA II
EXISTING — PROPOSED- I— Fd E3
0
ElTi�4.C,'d IIP
11ELE1111E
ED.E.ICATION-
BE..'. 0
PRM FE.Ul��
YES 0 No
E MARKS NAGE
WNE..NTBA1,T.B BE PONSIBLE FOR EROSION CONTROUDRA(
ADDRESS
33o
GINEERI.G ATE
wv z
_D� ,ITEIEIIINI 276--7373-
L
NAM
ADDRESS
FIRE REVIEWED By IF
CITY zip
TELEPHO
�ou e
VARjpI�R CU SHORELINE OR ADBN BOND
STATE LC N E NUMBER
IV DATE
CH Y
2bl�
:1,
AUT *lnFD
SEPA REVIEW SIGN AR A EIGHT
COMPLETE I EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED 0 m
PROPERTY CO T PARCEL NO.
0
rn
EXP 0
REOUIRED SETBACKS ITT.) PROPOSED SETBACKS (FF.)
LOT COVERAGE c
0 NEW RESIDENTIAL F�_UJVMING/MECH
ALLOWED PROPOSE FRONT SIDS REAR, FRONT UP I E BEAR
I
COMMERCIAL o COMPLIANCE OR
ao m
AUDITION cl CHANGE OF USE
PARKtio V11— .1 0-4
REMODEL 13 APARTMENT SIGN
PEGG ED C:
1
F
0 REPAIR 0 GRI CYDE JENCE
X FT)
F—E
TANK
DEMOLISH 0 X
0 c
R NiNG WALL
GARAGE : C] BETAIF RENEWAL
CARPORT QQ6 BX
CIHECKEOSY ITYPEO m rn
_qT C U T4 ::z 0
7 c 0
))CTfpN PAN
GROUP o
SPECIAL INSPECTORJA OCCUPANT 0 Fn
LOAD Cc
p jYPl IE, BUSIN SS OR ACTIVITY) EXPLAIN
NUMBER NUM OF
OF ElLEING
CRITICAL
AREAS
c STORIES UNIT,
'UM BCA-?'Mlr7
F OUIRED 0 YES M (03
,
REMARKS
DE RISE WO BE NE
14
ROGRESS INSPECTIONS PER UBC 10BIWINAL INSPECTION REO'D a
�'(AL F-rd= 11' P/
wal -*-' 0-11 1
De
d
VALUATION FEE
PLAN CHECK FEE 0
m
tATSIL
BUILDING
PLUMBING
PIN ClEl
VESTED DATE
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t:
BEDONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
ETC.) WILL BE DUBE
GRAGINGIFILL
DOMAIN S, SIDEWALKS. DRIVE AyS. MJRQUEES.
(CURB W
SEPARATE PERMISSION,
STATE SURCHARGE
PERMIT APPUCATION: 1110 DAYS
PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG, REVIEW F
SEEBACKO PINK PERMIT FOR MORE INFORMATION
NO INSPE TION FEE
P SUCCESORS
A PLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
'Ty OF
IN NTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THLJNY AND
WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM
LA DSCAPING
INSPECTION FEE
E MONDE,
LL
A LCI-AIMSFOR DAMAGES OFWHATLVER NATURE.ARISING ORECTL,
SHALL NOT BE
FF M THE ISSUANCE 0; THIS PERMIT ISSUANCE OF THIS PERMIT
0 CEANYREGUIREMENTOFANYCII YORDWANCE
DEEMEDT MODIFY. WAIVE OR REDU
PUNCH CK DEPOSIT
50
C, NOR LIMIT ION ANYWAY HE CITY SIBILITI TO ENFORCE ANY ORDINANCE PROVISION
RECEI T
TOTAL AMOUNT DUE
I HERESY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION, THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
STATE REGULATING CONSTRUC
CALL P
THEOWNER IAGREETOC WITH CITY AND _AWS
DIMPLY EMPLOYED
TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE L
RE ATING 0
011.1.11 .1 h.11h,, Deo,ty, a�d .1. P.Id.
FOR INSPECTION
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
DA
WORK.ENS NSURANCE AND RCY
OFFI I L SIGN AT RE
1
SIGNATUR G 1,'
(425)
6
I _uIr rw RELE Day DATE
If
�ENTION —
EXT 1333
IT IS UNLAWFUL TO USE 08 OCCUPY A BUILDING OR STRUCTURE UNTIL
1
771-022 X
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL FILE YELLOW-INSPE TOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK -OWNER GOLD�ASSESS R