20010576.pdf__'rRECEIVE�
C)
PERMIT EXPIRES
PERMIT 1
CITY OF EDMONDS
_s'3
USE
ZONE
NUMBER Z&1
APPLICATION
JOB SVITEJAPTO
CONSTRUCTION PERMIT
ADDRESS 19 M 6 7—
OWNE NAMEINAME OF BUSINESS
PLAT NAMUSUBDIVISION NO
LOT NO.
�D 00,
G FEE
MAILINGADDRESS
A)x.
PUBLIC FIGHT OF WAY PER OFFICIAL STREET MAI
EXISTING PROPOSED
IEIC 0
st— U., PN A, d 0
CITY �TE
ZI;
;6 ;Lh�;ONE
REQUIRED DEDICATION— FT
W d
"ic 0
NAME
P V RIOMIRED
'ES 0 NO 13
ADDRESS
M A RKS
REM
H E
OWKICONTRACTOR RESPONSIBLE FOR EROSIO�NTROLJDRA(%AGE
0 W C 0 N T
CITY ZIP
ITS LEPHONE
vmFinsocalw
NAME
c
z
GINEERING REVIEWEDIDATE
E N G IN E E. IN
0
m ADDRESS
/Z
AD IL /i tp
FIRE REVIEWED By E
IRS FEVI EWE
cl vp
_TELEPHONE
IS. m
In 0
0
0
V V , C I
A AN E
FIANCE On CU
SHORELINE OR ADSN
INSPECTi N
REG 'D
E3YES riNO
P10 D
OSTED
.E HE
ATE
10,7 ' —
SERA RE AEW
CO. S"A
COMPLETE I EXEMPT
PLS,E
EXP
EXP
SIGN AREA
ALLOWED , PROPOSED
HEIGHT
ALLOWED , PROPOSED
PROPERTY TAX ACCOUNT PARCEL NU.
h. -7
N LUM.N. I M'C.
EW
C] NE PLUMBINGIMECH
W )��SIDFNTIAI
S '4
'0 M'LIAICE On
DDiTIG. C ERCIAL ED COMPLIANCE 08
OMM CHAN E OF USE
N OUEE
E3 7A ANSE
REMODEL APARTMENT SIGN
0 E.ODEL7C3�
FENCE
0 REPAIR GRADING CYDS X FT)
LOT COVERAGE
LOT C.,
ALLOWED P
ALLOWED PROPOSED
REQUIRED SMACKS (FT.)
FRONT SIDE BEAR
I
PROPOSED SMACKS (FT)
FRONT UPSIDE REAR
_n
m
z m
0 -n
PARKING I LOT
RED D PROVIDED
AREA
I PLANNING REV' EWED BY E
we
"Ine
tg,.DEMOLISN C] TANK OTHER
ARABS ETAI
C It NINE WALL M RENEWAL
C' G
ARPORT BOCKFAY
F4CTIVITY)
m IT!
0
2 Fn
W
L"
0
'w-o -,ulo
BUSINESS EXPIN:
!L
1.
0 m IC
NU�ABER NUMBER F
CAR
OF DWELLING SAI -
STORIES UNITS UUM
CU NT
CUP
�ECIJALEIDNSPECTOA JAREA
'p
REGUIR [:] YES
OCCUPANT
LOAD
5
EMARKS
ER UBC 1081FINAL INSPECTION REO'D
PROGRESS INSPECTIONS P_
e-o
V? 4-
V I Ll
z
z
9
VALUATION
FEE
0
PLAN CHECK FEE m
LOT SLOPE I BUILDING 7
PLAN CHECK NO: 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 GRAGINGIFILL
SEPARATE PERMISSION.
DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE 7= 5
U ... R.E�
PERMIT APPLICATION: 140 DAYS
PERMIT LIMIT. I YEAR ' PROVIDED WORK IS STARTED WI HIN 180 DAYS EN. REVIEW I..
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
+
[5
'APPLICANT ON BEHALF 0 HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SLICCESORS END INSPECTION FEE
E I
N RE A RE INDEMNIFY. DEFEND AND HOLD 14ARMLESS THE CITY OF 7CANDSCA PING
I 'NTE S ST. G I S To I FC PLOYEES. AND AGENTS FROM ANYAND
ED D A 0 , I F I IALS. E INSPECTION FEE
L MON M - W 0 SH N M T ON TS 0 H ISAT
N USE, ARISING DIRECTLY OR INDIRECTLY RECEIPT
I F R DA AGES OF W ATEVER BE
A P LCLA H S ISS C F T I S PERMIT UANCE OF THIS PERMIT SHALL NOT
E UAS E 0 H PLAN CHECK DEPOSIT
F OM T NS REQUIREMENT OF ANY CITY ORDINANCE
E on EDUCEA ,
DEEMED To MODIFY . WAIV R In CE
0 AN A E TO ENFORCE ANY ORDINANCE PROVISION*
NOR LIMIT IN Y W Y TH C ITY SABILITY IPT
T .1 AMOUNT DUE Z05
I HEREBY ACKNOWLEDGE TH : HUE READ THIS APPLICAIIONI FORMATION APPLICATION APPRO �A�
GIVEN IS CORRECT AND T. AM THE OWNER, OR THE OULI AUTHORIZED AGENT OF I '. E
CONSTRUC F.. d.
THE El tAG E11000M LY WITH CITY AND STATE LAWS REGULATING CALL Z _
"0 WN IN DO , E Wo EMPLOY ED
NCAN H' 'T. R AUTHORIZED THEREBY, NO PERSON WILL BE L
.�.Iq.g p", pV6,t
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON HE AT.NO TO FOR INSPECTION
7
WORK.E COMPE41ON 14URANCE AND RCW IS 27 OF "I L SIGN URE 0
22 —PO" SIGNED (425)
F7 =4 o 771-0220 RE ASEDBY DATE
;X
ATTENTION EXT 1333 ---
T,S UNLAWFUL TO USE 'OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 K
A "AL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI- ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
I�E
SEP.1-1 2001 2:50PM HP LRSERJET 3200
ASBESTO-TEST
I N c o R P a R A T E D
-GOOD FAITN' ASBESTOS SURVEY
911 Maple St. Edmonds, WA 980_20
page I Of 6
IM210713
J* 17,2001
Ce GraMr, Im
P.O. Box 27145
Seattte� WA 98125
Attn: Cary Gmager 24210
ph: "&%2-%" Fu- 20&36
on July 11, 2001, Asbesto-Test personnel conducted a good &W' asbestm survey (Per
U.&E.P.AJA.H.E-R-A. guidelines as designated and specified by Puget sound Ckan Air
n. or i Mavk
Agency and waskingtoft State) a the Si le n cabi identify any
St. washiftionjoLa This survey purpose is I to prior to
C8 ona rompal
Asbestos Containing MtOiAls that may be present and will require prof si
deawliflon of the structures.
NjRfiAT1!T—QEL&D1lV0
9ASIC COKSTRUCTION (including siding androojing types) The main hoize is two story
wood ftame on a concrete and wood foundation. The exterior siding is wood. The wood siding
underlying material was sampled. The cabin is also wood framc: on a concre(c and wood
lbundation, The exterior siding is also wood with no suspect ACM located beneath the wood
siding exterior. The contposition roofing materials were s8mPled'
ATTIC/WALL INSULATION: There was no relatting suspect ACM located in either structure.
PLUMBING SYSTEM: There was no relating suspect ACM located in citherstTucture.
*INTERIOR CONSTRUCTION, yINISHES, "D FLOORINGS: The interior ofbaffi
the house and cabin is wood and drywaJI. The drywall and taping materials were uniformly
sampled. Vinyl and tik flowing materials with relating backjags and mastics were also sampled
per each located homogenous area. The acoustic ceiling tile was sampled per each located
homogenous are*.
C0?,,TIjV(jE TO PAGE 2
5117 Pager (206) 6"-4629
8003 156th ST. SE - SNOHOMISH, WA 98296 - (425) 489AD40 - Se.ni. (206) 523-
p. 2
fA;P I
M
0
0
-n
Rn
Z
5
At
SLP I'l 2001 2:bOPM HP LRSERJET 3200
July 17,2001
Page 2 qf6
Asbesto-Test, 11tc- (423) 489-4040
IAF#210713 91 Ed -ft- WdshiAld-OA-98—OLO
in e a -
CAI, SYSTEM. The electrical wiring insulation is not of the kind to he ACM and
ELECTRI
was not sampledl. Arry additional suspect electrical wiring insulation or any suspect n1
Mermai System hisulatiOn) found In, around, or behind any localedfuse or breaker boxes ise
should he considered to be ACM (Asbestos Containing Material), unless determined otherw
by laboratory analpis.
is a forced air floor furnace in the main
HEATING AND VENTILATION SYSTEM: There - There is also some
house. There is ACM TSI on some of the ducting beneath the housf to
d/wall electric heat in die house, There was no relating suspect ACM located relating
baseboar i ible relating suspect
the electric heaters. There is a gas wall beater in the cabin. 'Mae was no V151 at
ACM locate& Vote: it uws not possible to dismantle the heating systems and relating he
ducling (Where applfcable) to locate andlor evaluate any additional suspect ACM that
its, or associated in hidden areas. It is our opinion any
may be concealed. inside the un ana
ng systems should be coordinated by the project m ger
further handling ofthe heati . als are located
an"r abatement contractor. Ifory, additional relating suVect materi
molijioy4 any and all additional related sus)n9ct materials
prior to anWor during any de CM (Asbestos Containing Material). unless determined to
should be considered to be A visible rellatin
There was no g suspect ACM located
be otherwise by laboratory analysis
relating to the fireplace system in the house.
The window glazing material was sampled.
ADDITIONAL STRUCTURES ON SUE INCLUDED IN SURVEY: Them is 0 garage
riot siding is
adjacent to the house. The structure is wood frame on a concrete slab. The exte ing was sampled
wood. The wood siding underlyingmaterial was sampla The composition roof
along with the wi2q�.
# of3truclures included In survey: 3-one house, one garage, and one cabin
Requested by., Cary Granger
At er, B.Sc.
I p0i
, A
ns r, certifi, AJI.EKA.
.-'"dL#CLAT5327 IftPifts 8/18/01)
CONTR4M TO PAGE 3
P.
AAmT
INC.
D
tn�
0
M
C 2!
I M
SEP 1-1 2001 2:bGPM
HP LRSERJET 3200
July 17, 2001
Page 3 of 6 Asbeslo-TeSt, 1"c' (425) 489-4040
LV#210713 d . . . . . . . . . . . lin hl_ka�E�d__W" inwa 2802
le * __;;;iefid.s
IdeWied asACMor PACM in this report (an&for additiol.W1 mateti.11
Any and all oultErials' j 1,jer idodfled j&, ACM Ir PACJW,
aunciated with the structure (hot may be discovered anc
naw beprofewiona* abated BYA LjCEIVSED pROFESSIONAL ASBESTOS
A 0 ATFMFNT CONTitACTOR.
Quantities of asbestos for abatculeut asKssment andfor pricing for removal should
he determined by on site evslust'on' I MrHATER 'Ex-C AW0_dL49=
S4MpLM.#j A AS 0 MATERIAL.
AN IS ID ASBEST W FM Lj
yes I/ chyoodle 1/ 35-40% --fibrous
1.0) ACMTSI TAPING Drdt side ducting ron ACM cellulose
UNDER HOUSKvWh1e On a'
NOTE: THE INSPECTOR WAS NOT ABLE TO DETERMINE QUANTrr'F S OF AC"'
AS ADDITIONAL MATERLALS MAY BE CONCEALED
TSI THAT IS PRESFNT [IORS, OR WITHIN THE FURNACE
IM WALLS, CEILINGS, AND/OR FL4,
SSMF
WITHIN 'XT AND QUANTITY EVALUATION OF ACM
UNITIDUCTING ITSELF. ASSE PRICING FOR REMOVAL SHOULD BE
FOR ABATEMENT PURPOSES ANWOR
DtTERMINED By ONSITE, EVALUATION. FRIABLE uon-fibrow rostcrimb
2.o) FLOOR TILE yes /I chrysotile 1/ 2%
HOUSE top ftor 9" , 9" tile -color: groy adhesive, cellulose
2.1) MArtic yes It ebrYsOt'le 2% ACM
APPROX. 310 SQ. FT- ON WOOD , NON -FRIABLE non -fibrous materlids
3.9) FLOOR TaX yes // cbrywtue 2%
back bMzr&ce 9" x 9" Mecolor. brown stre2k
HOUSE asbcstos is in the kard t9C 3UrfU* Mat"'UL APPROX. 50 SQ. Fr. ON NON -
Note; The LE ACM
ACM LINOLEUM FLOORING, NON-FRIAB a
NAD dhesive, =Uulmc
3.1) tuffific G Yes // chrYsOfik no"brous materills,
4.0) SHFET VINYL COVFR'N
covering OR eabinets Is back Pomb HOUSE -color. beige brick
APPROX. a SQ. FT. ON WOOD, FRIABLE ACM
le /125-30% non -fibrous materiRls-
5.0) SHEET VINyL COVERING Yes /I chrysoti
coveflug on cabinet floor in Wk porch CABIN-cOlOr- Y"Bow Pebble
- ACM
APPROX. 10 SQ. FIr. ON WOOD, FRIABLE
yes if chrysotile It 2% nonfibrous materiAls
6.o) FLOOR TILE te ACM
FIOUSE-min floor bathrOO10 1" layer-oDlo, 'hi
()ORING, NON -FRIABLE
KON-ACM LINOLEUM FL hesjve� cellulose
APPROX. 35 SQ. Fr. ON I NAD ad
6. 1) nissfic
CA � -:! DT.
M
or A'
-40: 1
C.)
0
M
0
Z
0
m M
0
Z
iu�
SEP 17 2001 2:51PM HP LRSERJET 3200
P.
J* 17, 2001
FW 4 of6
Asbesfo-TeSf, Inc- (425) 489L4040
j7V0210713 in and ar
dKWI h
e a 91
BEST
nypFj/gU
ITV MA�TFIIIAL
ANALYSIS MY
IN ANY OF THE REMAUQN'G SAWMAN
7.0) wood siding vapor barrier
NAD
ceflutose, tar
garage
7.1) wood siding vapor barrier
NAD
cellulose, tar
bouse
NAD
non -fibrous materials,
8.0) window glazing
cellulose
prage
NAD
11011-fibrous materials,
9.0) drywall
cellulose, fiberglass,
9.1) drywall taping compounds NAD
HOUSY-SAMPLER PER AHERA PROTOCOL
10.0) drywall NAD
10.1) drywall t&PID9 CO-PuRds NAD
CABIN-SAWLER PER ABFRA PROTOCOL
11.0) ennipwition roaftag
NAD
and underlying materiftis-HOUSE
11. 1) composition rGofing
NAD
and mWerlying materia"ARAGE
11.2) composition roofing
NAD
and underlying ouiterials-CABIN
12.0) flat tomb down roofing
NAD
an back side ofHOUSE
13.0) scowde ceiling block
NAD
HOUSE living room (stapled up)
13.1) acoustic cdft block
NAD
HOUSE back entry (stapled up)
13.2) acoustic ceding block
NAD
HOUSE batlar-mi (itapted up)
14.0) AM vinyl flooring
NAM
HOUSE upstairs baftoom-col0r; white square
NAD
14.1) wastic-clear
paint, (gypsum)
non -fibrous materials,
cellulose, flbtrglass
non -fibrous materials.
cellulose, fiberglass,
paint� (gypsum)
nDri-fibrous gaterials,
cellulose, fiberglass
cellulose, tar, fibci-glass.
non-fibrotL9 materials
cellulose, tar, fiberglass.
non -fibrous materials
cenulow, tar, fiberglass,
non.fibTous materials
cellulose, tar, fiberglass,
non -fibrous materials
rellulose, paint
cellulose, paint,
cellulose, paint
non -fibrous materials,
cellulose, fiberglass
adhesive, cellulose
( _T
INC.
�6D
a
M
-n
rn�
c
C);
0
SLP 1'? 2001 2:51PM HP LASERJET 3200 P.6
Ady 17, 2001
page 5 of6
Asbesk-TC54 INQ (42S) 489-4040
B0210713
9 C'
wM
JANTITY
ANALYS
QXRER MATERIAL
15.0) linotgum flooring
NAD
non-fibtous materiaK
ccllu]osc� tar
GARAC-t-col0f: gray design
NAD
adhesive, cellulose, tar
15.1) masfien"liling
16.0) shed vinyl 1100TIAg
NAD
non -fibrous materi8l%
rellulosa� fiberglass
CABIN kitchen1halbbatb-color: gold pebble
adbeaivc� cellulose
in,
16.1) Mvdk-cleff
NAD
=1 q
17.0) sbeet viltyl flooring
NAD
non -fibrous materiaL%
cellulose, fiberglass
HOUSE kitchen and main badwoorn surfaCC-0010r: beigo square w/ blue
design
17.1) musfit-clear
NAD
adhesive, cellulose
0
18.0) abed vinyl flooring
NAD
non -fibrous materials,
cellulose, fiberglass
M
HOUSE kitchen 21 layer -color: cream pebble
NAD
adhesive, cellulose
18.1) nuastic-ciear
19.0) libolem flooring
NAD
non -fibrous materials,
HOUSE .-back hall e laYer-cOlOr' green
NAD
cellulose. tar
adhesive, cellulose, tar
"0
_n
19.1) nunfiefbackft
on cellulose flooring fat
20.0) linalmin flooring
NAD
non -fibrous materials,
HOUSE -back porch -col— Yell0W
SorhCeS
cellulose, tar
ff
Also 2" layer under ACM sheet vinyl on back Porch cabinet
adhesive, cellulose, tar
1C
20.1) mostic/ImcKmg
NAD
21.0) finok�am flooring
NAD
nan-fibrous materials,
HOUSE 4ath main floor bedrooms under carpeting -color: green
cenulose, tar
adhesive, cellulose, tar
21.1) wastlicibseldng
NAD
22.0) linoteurn flooring
NAD
non -fibrous materials,
ceflulose, tar
HOUSE -31 layer maln floor bathrocut UNDER ACM TILE -.color: tan
cellulose, tar
Z'
=I) MaStielbACIdag
NAD
adhesive,
A-T
SEP 17 2001 2:51PM HP LASERJET 3200
Page 6 of 6 july17,2001
INN210713 Asbesfo-TeA 1= (425) 489'4040
(on
SIAS* gmit, dwelffiez Obin. Pull rdAVO 011911 F,4Mnds Washlrw—
is ofiodj�id.aj W�djparaw,amplings andanalysil of
vome,awpte awlyses listed my be a
hmo�groous materials. wpmcribed hyA.H-E.R,A. piet"01.
Sampies taken= listed with their correspandhig Ifasbestos is driecfa� those samples 'onsiningasbesral
" Cm
am lisredfirst and noted with the inifi6l'
demolition or renavatim any additional hidden or covered suspect materials similar to those
if during ed [nW include but not limited to: sheef vinylflarAng, t1jeflooring wall
talcrettried in the survey ore locat
or cOlIng lmlw*Ws or paints, concrete siding or skirting, cementPiPes, cement �allboard electrical
cloth, electrical wiring insulation, thermal PaPer, wallboara� joint compoundr, vinyl wall coverings,
Im I System Insulation)], rhey should be treated as
Spackling compouigh, or any other suspect W MW-Ma
Asbestos Containing Materials unless derumined to be non-WbWfOs by laboratory analysis.
wbich may be
Note: Albeato,_Ttat Inc. does not guamatu approximations o(quantitles ofACK
listed w0b the "Alyms. it J, thenforre recommaded profmionsl abatement prke and/or dispoaal
quot" �ee obtained by inquiring as to few per area of sptc&c ACNI material (Le, square or linieur
foot, or by as site gm*34ment.
an ^werilris ideirtffied as A CM im this report mug be obatedprior to ACM dkourbamce,
Any aNd
renovadaR, or demolition. All materials identffled asACM jousl beprofiwionarlly abated by a ficeRsed
to W distarbgxce.
asbealm c "ent confradorilflOr
Wgyr� W,.IhW: USEPAWOM93/116—MM
LIN, ACM
PACH
CAB mWifi. -Co.-M A*.V— U..e,
I sianiks'l—Ibm"
IMI irifi. '11-1 sydm fta.6.e
RVAC iCHfiW"HeadUV."9ftAW-CWWO-M8"
NAD jgnjfi.1N�Mbea&%D"--W'
it. USIPA rlpl-WY liw f- -bw-� i- h1k "'Pk'
PLM I., h— &*er= d�e =MOM st&b Omain ObWxS, it, uptive PLM mw1w mMM be
g—.,.d
Aslao-rest' h.. Cku., ..Plt
EADOFREPORT
O"61yacal Chemist. B-SC.
AIHA 1)[0ficiew
Asa
P.7
M
M,
M
-40
C)
M
ID
C
0
M
:C)r
g
Ell
C'�
z
0
I
to
PW 6 of 6 Awly 17,2001
JN#210713 Asbato-TeSI, 1— (425) 489,4640
1 .4-1. W.
,;W,,
�,011 njtd may be � anotysts qj inatwa� � j4i�
W1.13, a, pwcrilmd by A H F- &A. PrOI0401, no ingasbestos
in
,e ustedfirif and nixed with the WilIGIS 'ACM"- covered suspect materials similar to those
f
, dtriW demolition o,. rewvatio,% any additional W*n of
deat#W in the "rM are located (may include but not limited to: ShM VinYtflOmIng, til"fl"r'"g, wall
Ir ceiling todurings orpaints, concrete siding or skirting, cementAlo", cement �UboarA el"ctricof
thermalpoper, wallboar,4 joint coMPOu"df, vinyl wall coveringj�
!loth electrical wiring twulatiOP& Syjwm Insulatkm)j, 11,,-y Shma be rreased as
Tackling co -POW&*, or any otiser sm . vect 7SI (lhffml nmbeitol by laborafolY MITYS13.
4,,bestos Conjaiig ffaeriais $,niffs,-ktarmined to be -
t g"Mgtee spproxiinatims ofquastities Of ACK wbich —Y be
Noic: AsbeaD-TtsU Isc. dow no t price andfor dispew
Uded with the anaIrm. It is &Wefcre ret�sded proft"10MI sbeftwen
qtmM be ObbdcLed by isqViring ag to Lw per am of specific ACK oxierial (Lt. square or Ham
rsot� elm), or by Gus site 811011616120t- jAh rQM mum be gbaledpriar to ACM d1swrbance.
Any anti AU MAIeFixis Uendfled as A CM In be Pfflf"WeRgUy absw by a Ucensed
r,MOvqtkft, or demdAlm AM N&aMrkFIT Idextyled ss ACM Must
MbTKW us m1bod; USEPA 60MI931116" RW
am ACM
,,CM ,,,,,.ft-,-5AbKMCMM14M"r
"B
W.50-Imban-
TM
IffVAC
NAP WfiW--D—W,
-.0.1 USEPA rnuk�Y jjs tW bW- b bulk —FIW KM fWdw—,O bo
, .W. tWh%d�,b=tAth-*Wu"
"hmbm"�ioaiwusbe%WM�P� W�a,�Ybmj�mWwjx,, jRunDP.C.M.P-
Fl�
d-f-I
EAM OFREPMT
ida
foal C;AMLV, A&
I
AMA PMFCICM
AA
I.,
few ED
M
M
M
IS
Z,
0
C
z:
0
-4
r,
i
M
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATIOW
Footing ......................
Wall..........................
Z,
0
Pier/Porch .................
5,
M
RelainIng Wall ...........
Slab insulation ..........
PLUMBING:
C3 M
M
Underground .............
Sough -in ...................
0 C,
Commercial Final
M 7,
10
HEATING:
Gas Test ....................
O'n
Gas Piping .................
Equipment .................
commercial Final
0 rn:
E)CrERIOR SHEATHING
NAILING ..........................
C-)f
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Z.
t
Calling Insulation
SHEETROCK NAILIN
M
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
7/1-7/191 'V6 -
\ v 6-4.1w%IJ uvflvj
-7
.. PERMIT
CITY OF EDMONDS .He NUMBER
CONSTRUCTION PERMIt APPLICATION JOB SUITEIAPTN
OWNER NAMENAME OF BU SINES ADDRESS
L'CATION
NAM
WNER rE- ME Z7 PITHA..L.DIVISIONNO. LID NO.
UD FEE $
MALI Lf N G AD D A E �§S
PUBLIC RIGHT OF WAY 18R OFFICIAL STREET MAP
EXISTING — PROPOSED 0
1 CITY ZIP ITELEPHONE 0
REQUIRED DEDICATION— FT 0
NO.OFFIXTURES YEPAV REQUIORED
NAME I S 13 N 0
r3 .-- --- 1 A=VS—T-1—A FIFI.MES11 FOR EA.SIONl..TRC)l-fDRAIMGE
ZIl ITE11PHOME
E
zip TELEPHONE
.�OA
�E LIOENP NUMBER IT"
0- G p A L
NEW
XRq.IQE.T..�6,j
PLUMBING I MECH
C3 AUDI TION
�.—MEFIMAL
C MPLIANCE OR
COHANGE OF USE
[3 REMODEL
0 APARTMENT
SIGN
REPAIR
—
1:1 GRADING CYCLE
F NCE
X FT)
9,-EMOUSH
0 TANK
OTHER
c3GARAGE
AETAININD WALL
0 RENEWAL
CAR OAT
7=
FOG en
ALM
1115 ul-��j I
NU Ben SEA CRITIC
AS
OF WELL. pUM —A/
STORIES M
0
1 1 DEsraB---
I OYES ONO
SEPA REVIEW SIGN AREA HEIGHT
I
0
COMPLETE I EXEMPT ALLOWED 1001-SEO ALLOWED I PROPOSED
W
P
FT)
A
LOTCOVERAGE REQUIRED SETBACKS CFT.j PROPOSED SETBACKS IT
A LOW ONT ,
L WED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
LO E` By E
PARKING LOT AREA PLANNING REVI.EWED BY DATE
REDD I PROVIDED
CH.:CKELO,�Oy
CIA
PEc7AL IN.6CT... AAA
Y
REQUIRED 0 YES
x- VL I &I LA
If
CURANT
GROUP
—[6L.62UIANT
uBc io8lFINAL INSPECTION
VALUATION I FEE
PLAN CHECK FEE
HEATSOURCE
LOT SLOPE %
BUILDING
PLAN CHECK NO:
IVEITED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THCWORKNOTID THIS PERMITCOVIP WORKTO
NAT PROPERTY ONLY A N,.O.STRUCTIO ONTHEPUB
GONE GNP. -
GRADIII GIFILL
UUC
B E.AY.. An.. C.)WILLREQ IRE
CLASS. S, K . V SEE, ETN
2 D..Al. DEWAL DIR
L;
SEPARATE PE AMISSIGN.
E SURCHARGE
PERMIT APPUCATION: 180 DAYS
PERMIT LIMIT-. I YEAR . PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, 01 BEHALF 01 "IS OR HER SIOUIE. EIAE. AISI.NS AND S e ES AS
AND HOLD HARMLESS T "Y
ENO. INSPECTION FEE
IN IN EREST. AGREES To INDEMNIFY. DEFEND
D 7 S MPLOYEES ANDAGENTSFRO ANY A
E MONDS. WASHINGTON. ITSOFFICIAL E
E, NATURE' ARISING DIRECTLY CAL DIRE T Y
0
ALL CLAIMS FOR DAMAGESOFSW=
RECEIPT
x FROM THE ISSUANCE OF THI ISSUANCE OF THIS PERMIT SHALL NOT
ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
9 DEEMEDTO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF
0 OVISION.,
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION '
TOTAL AMOUNT DUE
RECEIPT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLI ATION APPROVAL
I GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
g 4" ".
CONSTRUC
THE OWNER, I AGREE TO CO P LY WITH CITYANDSTA LAWS-EIGNULATiNG -MP ED
CA L
L,— D.Puly L,,,d V— P-1
K, W.
TION; AND IN DOING THE 0 K AUTHORIZE THEAEO�ENOPEAS W L EL
N nG THE 0 FIELATILNOGYTO
O.P
FOR INSPECTION
I THE L CODE OF THE STATE OF WASHINGTON
IN V1.11ALKT N
CRIME COM IJURANCE AND RCV? 1827.
W K.,
F C L IGN U
DATE SIGNE
S,DN76 t7� 0
(425)
771-0220
RE ASED By E
EXT 1333
ATTENTION
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
FINAL INSPECTION H AS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGMAL-FILIS YEULOVY- INSPECTOR
ASSESSOR
A
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER GOLD -
z
0
�n
C3 M
c 0
m 0
0
c
m
10
om
m M
0 r
RE ca
m 0
z
m