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20010556.pdfDATE R IV 1301 ----] - IPERMIT EXPIRES Ids- USE CITY OF EDMONDS ZONE =-wo�—osS SUITEJAPT- CONSTRUCTION PERMIT APPLICATION 'AODBD A E S S rl k3o t4 OW N E A I A EMAM.E O.F OU SI N& FLAT NAMEISUBDIVISION NO LOT NO LI LID FEE S MAILING ADDRESS 1E.IAN— u PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP P.— A-- 0 P ,1 0 EXISTING � PROPOSED— 13 13 CITY ZIP 0 FT — REOUIREDDEDICATION— WI-1.1—d EOULAED NAME METER SIZE LINE SIZE NO, OF FIXTURES Y,PRV so NO 0 ADDRESS REMARKS OWNEWCONTRA=R RESPONSIBLE FOR EROSIONCONTROUDRAIMAOE C ITY ZIP NAME �A ED[DATE ENGINEERING OGRESS FIRE REVIEWED By DATE CITY VARIANCE OR CU ... A��,NE A.B. -LNTp5-_-i-i-W-F-o:TED STATE LICENSE NUMBER OYES E3NO �G- AREA SEPA REVIEW S PRA HEIGHT OF F, EXEMPT AL ED P BED ALLOWED PROPO CO SED PLETE RC L NO. PROPERTY TAX ACCOUNT PARC I A LOT COVERAGE REOUIRED SETS CKS(FT) PROPOSED SET C 0 NEW C] PLUMBINGIMECH ALLOWED PROPOSED FRONT SIDE HEAR FRONT pAR III E EAiR C] AODITION COMPLIANCE OR CHANGE OF USE PARKING LOTAREA 1PLANNINUK-1—t— REMODEL E3 SIGN REO'D PROVIDED REPAIR C] GRADING CYGS 0 FENCE X FT) 0 DEMOLISH TANK o OTHER GARAGE 0 RETAININGWALL RENEWAL CARPORT (TYPE USE. BUSINESS OR ACTIVITY) EXPLAIN: CHE ON 'KED B:FE OCCUPA AD, P Irv?- 1.0 ITYPE ;CON7W 1, 0, CRITICAL NUMBER N'EsE"G ""C U DUM G LL 'TF :_CIAL 1; SPE CTOR REOUIRED AREA OCCUPANT LOAD OF I MBER LIN IS NUM 0 STORIES IS N. C] YES DESCRIBE WORK TO BE DONE 5PECTION REO'D L CID 7WE VALUATION FEE PLAN CHECK FEE HEAT SOURCE GILAZING % LOT SLOPE I BUILDING PLAN CHECK NO: VESTED DATE PLUMBING MECHAIIICAL NOTED ' MIT COVERS W.AK TO THIS PERMIT AUTHORIZES ONLY THE WOLRIK TAUCTI.N ON E PUB BE DONE ON PRIVATE PROPERTY ON A.1.6N;H WTH UUC OMAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) IlLR ED IRE GRADINGIFILL :3 SEPARATE PERMISSION. I: STATE SURCHARGE 2 PER I MIT APPLtC&TION '00 GRAYS ITHIN III DAYS I PERMIT LIMIT. I YEAR AOVIDED WORK IMSSTA TEDRW ENG, REVIIW FEES FOR OAENFO M SEE BACK OF PINK PERMIT ATION 'S"G A"'U" :ANTONBEHALFOF.ISOR ERSFEONUDE H 0 AA`-LES-T-EC`�T'y';" PPLII A&D H DE QEH END INSPECTION FEE LANDSCA—E A OFF I.S. EMPLOYEES. AND AGENTS FROM ANYAND !I IN INTE '.=T.T�0 :T�DE=IIFY �kge'S'T INSPEC71ON FEE 2 E OMONDS iwF ADANA A N DIRECTLYOR INDIRECTLY t �ATU HE. RISI LA 0 6 F�HA E CE OF THIS P RMIT SHALL NOT BE ALLC I RECEIPT PLAN CHECK DEPOSIT I M PE III ISSUAN FROM T M E E OF T IS R�V I A MENT OFIANY CITY ORDINANCE HE ANC CEANY EOU E SU IV OR� EDU A - ECITY M 0 l�y DEEMED 0 �WA To OR S 51LITY70 NFORCEANY DINANCE PROVISION 1. NORLIMIT IN ANY W YTHE A E AEC TOTAL AMOUNT DUE '�,�SAF�p',,�CEATIULY. I.AT IHE INF AVIATION I HEREBY ACKNOWLED13E THAT I NAVTEREAD AND THAT I AM ' E WINE , G AUTHORIZED AGENT OF T'll 1, "1 GIVEN 15 CORRECT. T A j E WSA AGREE TO COMPLY WITH Cl Y.- EGULATING CoNsTRuc I TAT `A CALL B"J_g O'K..' D.Puly; .,XI F... .1. F.. THE OWNER, TNb No PERSON WILL BE EMPLOYED TION. A NO IN DOING THE WORK AUTHORIZE 1) RELATING To p", .1-11ldgl— p.. p—ld.d. FOR ENEREBY. IN VIOLATION OF THE LA50R CODE OF I -STATE OF WASHI NGTON M�S SIGNATURE T; WORK.ENS OMFENSMIONINSUPANCEANDRC 1827 OFFI SIGN , AGE I) DATE SIGNED in-ol (425) 771-0220 .�LE ED EXT 1333 N IS UN F 0 USE OR OCCUPY A BUILDING 08 STRUCTURE UN 'j 771-0221 YELLOW -INSPECTOR IT INSPECTION HAS BEEN MADE AND APPROVAL OR A CERT ORIGINAL -FILE GOLD -ASSESSOR A FINAL HAS BEEN GRANTED. USC SECTION 109 FAX PINK -OWNER CATE OF OCCUPANCY z 0 0 m C= rn 0 80 c m m 'o ca 0 mm a 0 o Fn C 0) m (j) T im 0 z 9 0 m INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing...................... Wall .......................... Pier/Parch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -in ................... commercial Final ...... ---- HEATING: GasTest .................... --------------- Gas Piping ................. - Equipment ................. Commercial Final EXTERIOR SHEATHING NAILING .......................... FRAMING........................ FIRST FLOOR FRAMING INSULATION ................... Floor Insulation Wall Insulation ........... Calling Insulation SHEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR... ui�-o OCCUPANCY ............... A Zi F. M A A z M M,4,wShw� �idv CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION O�1,11 N4MlfNAMl OF IUSIN�IT, Y�A 3 MAILINGADDRESS N z \ -s "_' A,,, �J CITY ZIP ITELIPHO E c t"'INC, u NAME ZIP [TELEPHONE ADDRESS ZIP I TELEPHONE Q FP—ERMIT EXPIRES USE ZONE PERM T NUMBERJ6(j� JOB ADDRESS PILAT NAMUSUBDIVISION NO. LOT NO. LID NO. LID FEE 5 J�U.Ll. FIGHT 01 WAY PER OFFICIAL -FEET MAP EXISTING — PROPOSED � l=d— RR,�,dw 0 REQUIRED DEDICATION— FT cl MO. OF FIXTURES IRED :RVRl. YE Cl NO 0 ARKS DWNFR�GNTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE 0 NEW 0 RESIDENTIAL 0 PLUMBING/MIECH 0 ADDITION 0 COMMERCIAL 4", &. COMPLIANCEOR o CHANGE OF USE 0 REMODEL 0 SON REPAIR 0 FENCE K FT) 0 DEMOLISH 0 TANK 0 OTHER 0 GARAG E CARPO IT 0 RETAKISNRINYGWALL ROO 0 RENEWAL (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: Oj eo r 4 DWEL NR 'TORIES AU DESCRIBE WORK TO BE DONE I L, A_ X: AJ FIRE REVIEWED BY DATE VAC41ANCE OR CU SHORELINE OR ADBN INSPECTION REQ*D 1 PBON OSTED E3 YES E3 No SERA REVIEW SIGN AREA HEIGHT COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED : , I I , Lo COVERAGE — 7EOUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR WQNT URSIDE REAR PARKING LOT ARUTPILRNNING REVIEWED BY - DATE REDID I PROVIDED I , JC"ICKIDBY ITYPEOF N7;FX 0 CUPANT C GROUP jit.3 I S I OCCUPANT RE LOAD REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D VALUATION I FEE A N K FEE PLAN CHECK FEE P L C HEAT SOURCE GLAZING % LOT SLOP' % SLOP' " U BUILDING LID N Intl> 1� p PLAN CHECK NO: IVES TED DATE 'H" ' PLUMBING P 'U M N -_ MECHANICAL M E -HA N 'CA L - WORK To THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO HE PUBLIC BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE ICF I L GRADING/FILL OR L SEPARATE PERMISSION. jl�N 3 PERMIT APPLICAT"' : 183 DAYS STATE SURCHARGE B PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES R VI E SEE BACK OF PINK PERMIT FOR MORE INFORMATION ENG, INSPECTION FEE G 'A PLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCCSOPS THE CITY OF S S T T IN NTEREST. AGREE TO:NDEMNIFY. DEFEND AND HOLD HARMLESS 1" ANDSCAPII)G R 0. Y 2 EDMONDS, WASHINGTON. TSOFFICIALS,EMPLOYEES. AND AGENTS FROM ANYAND G 1 0. INDIRECTLY A CL;%IMS FOR DAMAGESOFWHATEVER NATURE.ARISIN D LL R INSPECTIONFEE RECEIPT SH LL NOT FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY TH E CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' EIPT 73A71 I TOTAL AMOUNT DUE IRE Vftl I HEREBY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROV�AL GIVEN IS CORRECT. AND THAT AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF TN. ,Y THEOWNER. IAGREETO WITH CITY AND STATE LAWS REGULATING CONSTRUC- COMPLY BE EMPLOYED CALL �O.Puly: 7,dFP..dd B."'g ON."aplW1. TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL OF THE STATE OF WASHINGTON RE LATING TO I,do.d 1, w o'-d'd. FOR INSPECTION IN VIOLATION OF THE LABOR CODE WORKMEN S COMPENSATION INSURANCE AND RCW 18,27, _�l IGNE. (425) OFF] I�SSIGNA A TE �IAT.? _714070T; 771-0220 AELE ED ATTENTION EXT 1333 /DAT� IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-022 1 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW - INSICCI-R X CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK -OWNER GOLD -ASSESSOR z 0 4 0 ofn ", , 1 �;, 80. 0 n m M z 0 m