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20010552.pdf1211,4-' 71,1� PERMIT EXPIRE F S CITY OF EDMONDS USE PERMIT ZONE UM.ER-,� SUIT(DA— ADDR ESS Awt"v CONSTRUCTION PERMIT APPLICATION jos 511E. NAME lll"p� E �11 FIL&T N-CiSURDIVISION NO _�GT —No- I L�D NO D FEE S o PURL.� RIGHT or WAY 11. CIFICIAIL STREET MAP EXISTING — PROP GEED REQUIRED DEDICATION-- FT I,-, U.. 1— A. d oO o a 0 17 20 A METER SIZE LINE SIZE NO.OIFIXTU ES PRV REQUIRED YES 13 No 0 ADDRESS REMARKS 4ESPONSIBLE FOR EROSION CO�TFOLJDRAIIAGE If I pt K-6 77 4ktt'17-70 ZIP 2A TELEPHONE -2-1 X AD R SS FIRE REVIEWED BY DATE CTY ZIP 2 TE111"Ol - VARIANCE On OU SHORELINE OR A.B. TATE LICE EXPIR 1014 DATE CHECKED By SERA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED ALLOWED Pro S,O PROT�;TAXACCO TFARCM I 2�G I I I �l I EXP x LOTCOVERAGE REQUIRED SETBACKS IF T PROPOSED SETBACKS FT) NEW (�Ec. ALLOWED /ROPIIED FRONT SIDE REAR rRONT UR DE REAR �j, z ADDITION O.PLIANCE OR E3 CHANGE OF USE 5, RKING E Y ATE Y R MODEL SIGN =M� �REV REPAIR C3 GRADING C,CS FENCE X FT� DEMOLISH [3 TANK OTHER C3 GARAGE E] FSTAIININD WALL C] RENEWAL CARPORT R C ER OR ACTIVII Y) EXPLAIN, (TYPE OF USE. E�USINESS o M� L2: 11ECKEDBY TYPE IF CONSTIFUCIION �_l CO E OCCUPANT ROUP B F NU.aER U END N `.EN Go, NUMB OWELLIN EW TO c I I AL F` S A EA SPECIJALEIDNSPECTOR JAREA OCCU 1A.T LO �Ao c' OF STORIES E UNITS NRU.SE R 1,55 U R RED E] YES D ;;� ME REMARKS PROGRESS INSPECTIONS PER BC 1081FINAL INSPECTI'D. I... 14 A,,sp LrtJ VALUATION FEE ;2 1?0 PLAN CHEC� FEE BUILDING ED DATE PLUMBING MECHANICAL PERM17 AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORIK TO 3E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE,IUBLIC GRADINGIFILL DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS , MARQUEES. ETC.) WILL F EQUI E ' SEPARATE PERMISSION. PC ARGE STATE So R PER.ITAPPLICATI-N: 1-0 DAIS STARTED WITHIN 180 DAYS FEES 0 PERMIT LIMIT. I YEAR - PROVIDED WORK IS SEE BACK OF PINK PERMIT FOR MORE INFORMATION ENG. REVIEW 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS ENG, INSPECTION FEE IN NTEREST. AGREES TO NOEMNI Y, DEFEND AND HOLD ARMLESS THE CITY OF LANDSCAP NG EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANYAND INSPECTION FEE ALLCI-AIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY NOT BE RECEIPT SSuANCE OF THIS PERMIT SHALL HIS PE RMIT E ROM THE ISSUANCE OF T EANY REQUIREMENT OF ANY CITY ORDINANCE DEEMED To MODIFY. WAIIEOF REGUC PLAN C ECK DEPOSIT 0 NONOMIT INANYWAYTHE CITY'S ABILITY To ENFORCE ANYORDINANCE PFCIISION, TOTAL AMOUNT DUE RECE 7 -7 I)u IHERLB ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT I A. THE OWNER, OR THE DULY AUT-RIZED AGENT 01 TI,.. PlIK-11- - 0—I " �l - T E OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC BE EMPL ED CALL BI.ldllg Otflc-al �l ,p,ly: M,d F .11 P.�d, NCN AND IN DOING THE WORK AUTHORIZED THEREBY. No PERSON WILL CODE OF WASHINGTON RELAT'NoGYTO FOR INSPECTION p— pl IN VIOLATION OF THE LABOR 01 THE STATE WORAMENS COMPEN5ATtONINsUFANCE AND RCVV 18 27 (425) 771-0220 RELE s DATE ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BIAIDING OR STRUCTURE UNTIL If I I 440 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW INSPECTOR CATE OF OCCUPAN Cy HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER - GOLD - ASSESSOR 0 m =I �n 0 m m 0 0 0 C C: 0 n m M 0 o Fn m 0 ;D z 0 1 0 m TV t 1194 Has ]PV 5'..4f A k ZONE— 6,A-'I;fATlAr4 r-,.�Pr c"t4r" CJL-A-5 SESCM- FRONT— SDE— f. FEAF-- one_ WW— FINAL P TO:_ DATE: — MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: ---- ;—_ FIRE DEPARTMENT DATE — ENGINEERING DIVISION DATE PLANNING DIVISION DATE-- PROJEC SITE ADDRESS — INSPECTED PERMIT DESCRIPTION OF WORK TO BE INSPECTED—*9-- A field inspection was conducted to determine rtnal compliance with approved plans. Final approval denotes that there are no ObJections from the above signed Department to the release of pERF RMANCE BONDS and the granting of: GRANT FINAL PROJECT APPROVAL GRANT PROJECT APPROVAL VVrM CONDITIONS NOTED 0 Copy of CONDITIONS given to owner/contractor by inspector 1. FAILED FINAL INSPECTION - OUTSTANDING ISSUES r by inspector j3 Copy of CORRECTION NOTICE given to owner/contracto 1. 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date_—� Sign__---� ocaprvl.doc.l:temp:bldg:formsIO101 z 0 M 0 0 a: M M z r') --I C Z (n o -n n M M 0 6 0 r- 0 M a 0) 90) M z X z cn z 0 j 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS .............. rA S FOUNDATION: Footing...................... Wall.......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground Rough -in ................... Commercial Final HEATINGi` Gas Test .................... Gas Piping ................. Equipment .............. Commercial Final: EXTERIOR SHEATHING Qe, 0 NAILING .......................... FRAMING ........................ FIRST FLOOR FRAMING INSULATION ................... Floor Insulation Wall Insulation ........... Ceiling Insulation SHEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY ............ .... A06 I- 066-t:2 / z d C) MID —1 C), 0 A z 0 n mm Fn M 'DATE RECEIVED PERMITEXPIRES CITY OF EDMONDS ZONE .. e6-1,12- PERM T N U M BE R4&- m / All N lt7-qt I �) 4//"- SUITFJAPT9 CONSTRUCTION PERMIT APPLICATION JOB ADDRESS �ss PLAT NAMEISUBDIVISION NO. L07 NO, LID FNO. LID EE S I MjqG ADDRESS 02-1 OCt^iN PUBLIC RIGHT OF WAY PER OFFICIAL STREET ;AP M RM- ZIP C', TELE HO [�DMQN[); W20 EXISTING � PROPOSED- REQUIRED DEDICATION- FT I -ACLr)-A-4-1A1AAr- METER SIZE I LINE SIZE I NO,OF1IXTUnES P8V REQUIRED Yes 0 No 0 ADDRESS P I OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRNNAGE Z, z z m 4 9 m c: ma 0 ME m� z 0 -n m M 0 0 o Fn z AFZ14P 1i !:��'�JIA T122 _ ) - 0"" ;�X -- -7'M NAME /*-*e IAI"I- /*r/j ENGINEERING REVIEWEDIDAT A 5. TISS FIRE REVIEWED By DATE Z111 WA TELE1 ON VARIANCE OR CU SHORELINE OR ADEN INSPECTION REQ;�Vo YES POSTE 1 50" tTATE LICENSE NOMBER EXPIRAT E CHECKED BY SERA REVIEW COMPLETE EXEMPT 'XP SIGN AREA AL OSE 'H9IGHT PROIE :�:TCQ-UNT'25" 00 NEW RESIDENTIAL F. 1E.. 19 CLU OMPLIANCE OR ADDITION 0 COMMERCIAL 0 CCHANGEOFUSE REMODEL 0 APARTMENT SIG. 13 0 FENCE REPAIR C] GRADING CID� X FT, C3 DEMOLISH C] TANK o OTHER GARJ%GE RETAINI., WALL RENEWAL z 0 IARPOIIT H.H., .0 LOT COVERAGE ALLOWED ROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE HEAR PROPOSE6SETSACKS(FTj FRONT UR DE REAR PARKING L)TAREA REaD PROVIDED I p-L-V r ;DATE tt REMA ARM r- c. n 6LI a (TYPE OF USE, BUSINESS OR ACTIVI [y) EX -IN A. 21' CTION GO E OCCUPANT E0111) BY ITIPE OF CONSTRUCTION GO E OC PANT CH GROUP GROUP NUMBER OF !�2 o STORIES NFEROF 0 ELLING U ITS CR ITIC L AREAS U N MBER SPECIAL INSPECTOR JAREA REQUIRED Fj YES OCCUPANT LOAD DESCRIBE WORK TO BE DONE m en�� REMARKS IN', PROGRESS INSPECTIONS PER LIBC 1 OaTINAL INSPECTION REO'D tr-n)9&f" noo VALUATIO FEE HEATSOURCE I-1p PLA CHECK FEE BU UDING ':2 1? - z 01 0 m PLAN VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Be DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 'CRADINGIFILL DOMAIN (CURBS. SIDEWALKS, DRIVSWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. STATE SURCHARGE PER IT APPLICATION: 180 DAYS 0- PERMIT LIMIT. I YEAR MROVIDEO WORK IS STARTED WITHIN 100 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION ON BEHALF OF HIS OR HER 11OU". HEIRS, ASSIGNS All 111C11111 0 FEE ;AP'PLICANT. N NTEREST. AGRE ES To DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING ;NDEMNIFY. EDMONDS,WASHIIGTON TS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANYAND INSPECTION FEE ALLCLAIMS FOR DA.AGEiOF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY NOT FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT HALL CBE E PLAN CHECK DEPOSIT DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINA PROVISION., 0 NOR LIMIT IN ANY WAYTHE CITY-SABILITY TO ENFORCE ANY ORDINANCE TOTAL AMOUNT I ACKNOWLEDGE THATI HAVE READ THIS APPLICATIULNY. THATTHE INFORMATION APPLICATION APPROVAL I HEREBY ,,,, ANDTHATA.T.E.,,NE O;ATH C AUTHORIZED AGENT OF ,HVEN IS C.H CT. 11 E D T h" P-' u"' `0- �1 THE.WNER 'A F�ET.Go.'LY.IT'C"YAN6S E LAWS HE GULATING CONSTAUC . CALL D-1, .�d I.. B"I 0 . -- P- TION, AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED 10 FOR INSPECTION IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASH. NOTCH RELATING 0 INSURANCE AND RCW 111.21, WORKMEN'S COMPENSA!,10N 0 ICIALS SIGNATURE 'R (425) a ica 771-0220 1EL711D11 EXT 1333 ATTENTION OR C.11 A BUILDING OR STRUCTURE UNTIL 771-0221 IT MS UNLAWFUL TO USE p HAS BEEN MADE AND AP ROVAL OR A CERTIFI- YEULOW- INSPECTOR A FINAL NSPECTION I CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR