20010589.pdf—j DATE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
C' NER NAMENAMEOF BUSINESS
Rugh S. Ferguson/Edmonds office Bl
M ILING ADDRESS
601 Union Street Suite 5523
CITY I, TELEPHONE
Seattle. WA 98101
[PERMIT EXPIRES -
PERM T
ZONE ge— "'BIER
8�'
jou SUITUAPTO
fi�DDREIS IV 2.d A,.. S. Edmonds, WA.
FLAT NAME)SU8DIVISION NO. I LOT NO, LID 10,
LID FEE S
P —�--
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP — F.—d
—=R
EXISTING — PROPOSED
REOUNRED DEDICATION— FT U—g'—
WId.q.W.d
!j�URES Y PRY RIOUIREO
X NO 13
I MARKS
OWNER/CONTRACTOR RESPONSIBLE F INAGE
;pattlg. WA 4K-IUI--v
NAME
Auburn Mechanical, InC.
ENGINEERING REVIEWED/DATE
G IN IN
70DRESS
PEERG
FIRE REVIEWED BY DATE
P.O. Box 249
7Y
TELEPHONE
;ZIP
Auburn, WA 980:7::1::
�53 ) 838-9780
(253)
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VARIANCE OR U
VARIANCE OR CU
SHORELINE OR ADS#
INSPE OTIO
RE C OSTED
oy�S ON. IF"
- F ON T
PI
STATE LICENSE NUMBER FXPIRA31ONI—A E
AUBURMI 163 BA 9/01/2001
I CHECK—Y
FF
C... PLET A CW
C EXEMPT
COMPLETE EXEMPT
SIGN AREA
ALL ED , PROPOSED
OW
HEIGHT
ALLOWED I PROPOSED
PROPERTY TAX ACCOUNT PARCEL No- 4548-001-023-0002
D 0 1 0 000
dr,411-
�V
EXP
EXP I
RESIDENTIAL XJR PLUMBING I MECH
LOT COVERAGE
ALLOWED PROPOSED
REOUIRED SETBACKS (FT.)
FRONT SIDE REAR
E-D SETBACKS (Fr.)
FRONT, yRStDE REAR
I
[3 ADDITION X)a COMMERCIAL COMPLIANCE OR
'HANDS OF USE
C
I
PAR IN
LOT AS ED By DATE
0 REMODEL C] APARTMENT 0 SIGN
REOD I PA VIDED
C] REPAIR 0 GRADING CY.S 0 FENCE
I X FT1
EMANKS
C] DEMOLISH 0 TANK C] OTHER
o GARAGE C] ISIETAINRiNyG WALL RENEWAL
CARPORT OCK
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
Office nujiding
CHECKED BY
TYP F 0 TR CTII N
C GROUP
277 ....
—WU—MBERr7.N"UQE,F
OF
STORIES
_ ME
OW LL,
UNEL!��
CRITICAL
AREAS
NUMBER
S IAL INSPECTOR
PECIAL INSPECTOR
REQUIRED C] YES
ARE OCCUPA
LOAD
DESCRIBE WORK TO BE DONE
___Ij,Staj_l_.p 11 ing
=RKS
.. �q IM'%0FrTI0NS PER UBC i081FINAL INSPECTION REQ'
VALUATION I FEE
PLAN CHECK FEE
'LAN CHECK FEE
HEAT SOURCE
LOT SLOPE -,o
BUILDING
(�'\ /A
P&A C;T N
1-1 ED DATE
PLUMBING
MECHANICAL
K T
THIS PERMIT AUTHORIZES ONLY THE WORK THIS PERMIT COVERS WORK TO
I
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
C
GRADINGIFILL
I
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MAROUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
EAY�FCHARGE
57—
PE MIT APPLIC.1`014� 1113.-s
P E
PERMIT LIMIT. I YEAR - PROVIDED WORK'S STARTED WITHIN 180 DAIS
PERMIT LIN T I A. P'
:E
END REVIEW FEES
SEC BACK OF PINK PERMIT FOR MORE INFORMATION
SE K OF P.
ENG INSPECTION FEE
PLICANT. ON BEHALF OF Is OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCE$OFS
.APPLICANT ON -C HALF OF H 'E
;A Y F
NPINTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
P S TO IN� '
C
I N E EST A B
"'T -
LANDSCAPING
AN-S FIND
N Y AND
I EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
0 ITS
I E MOND WAS-IN-T N
C S
S . E
F EC N E
INSPECT iON FEE
RECTL
C ALLCLMMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
ALI C"MEFoF DAMAGES OF
RECEIPT
NOT BE
4 ALL NOT
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SH BEE
FROM THE ISSUANCE OF TH,
PLAN CHECK DEPOSIT
PLAN CHECK DEPOSIT
'C
CE ANY REQUIREMENT OF ANY ITY ORDINANC
DEWED TO .�'F Y WAVE C' NA E
DEEMED To MODIFY. WAIVE OR REDULITY PROVISION,
I NOR LIMIT IN ANY WAY THE CITY'S AW TO ENFORCE ANY ORDINANCE
NORUMFTNANYWAY THE
TOTAL AMOUNT DUE
RECEI
I HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION. THAT THE INFORMATION
APPL ATION APPR6VAL
GIVEN IS CORRECT. AND TH AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
AT
T -1. 7 u"
rFUC
THEOWNER IAGREETOC o MPLY WITH CITY AND STATE LAWS REGULATING CONsrFUC
D
L
CALL
8�.I "V DIy, nd Foll d.
B
ONWI BFEMILOYE.
TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PEASNGTOLL
T
OF WASHI N RE ATING TO
17
FOR INSPECTION
S
1— P- -,.d .. PI--
IN VIOLATION OF THE LABOR CODE OF THE STAT E
WORKMEN S CqVPENSATION INSURANCC AND ACW 18 27
OFF, I
;�EZ
SIGN
SIGN
SIQNAJ�;O IQWN
C IE�
D E SIGNED
(425)
(425
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106-1`1 -01
771-0220
RE
bATC
EXT1333
ATTENTIOW
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
AND APPROVAL OR A CERTIFI
771-0221
A FINAL INSPECTION HAS BEEN VIADE
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK OWNER GOLD - A55ESSOR
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RECORD OF INSPEMONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
10 vo
Underground .............
Rough -In ...................
Commercial Final
HEATING:
GasTest .................... ---------
Gas Piping .................
7 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
OCCUPANCY ..................
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C ITY OF EDMONDS
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UM.
CONSTRUCTION PERMIT APPLICATION ADDRESS
. SUITEJAPT4
OF
131 2nd Ave. s. Edmonds. WA.
OWNER NAMEINAME OF BUSINESS
4
P_ LOT NO, LID No.
PI.JT NAMEISUBDIVISION NO.
Iff
Hugh S. Ferguson/Edwondd office Bldg.
UD FEE S
MAILING ADDRESS
601. Union Street suite 5523
PUBLIC FIGHT OF WAY PER OFFICIAL STREET MAR
EXISTING — PROPOSED o
o
CITY
ITELEPHON1
Seattle, WA 98101
RE.W.E.IDEM.-I.14— FT _ D
METER SIZE LINE S111 NO, 01 FIXTURES PAV REQUIRED
. YES)( NO 0
_ 7 11 , -:5 5
_ _
NAME
PKJ13 Architectural Grodtl�
i5,'
REMARKS -—Al F FnR EROSION CONTROUDRAINAGU
-�--CoNT ACTO..E.P.N.I.I-EI.RE...I.14 N RW
Do T oL
LADPRESS
it St
60 St w ht S
cI7 ZIP
NE
Seattle, WA I a 10 1
ITELEPH
(206) E624-3210
MREMA
N Am'
NAME
Auburn Mecha-4-11 Tnr-
n e h
U Ur M c
A b
ENGINEERING REVIEWEDMATE
N NEER N REVIE E
E I 'o
AODR111
I *_ �!o X 24,
i'.o.-Box 249
P ' 0
FIRE REVIEWED By DATE Z
FIRE FE"EWE.Gy
CRY zip
C
TILEPHO I
IZ
Auburn WA c"I -11
Auburn WA
f953)
VARIANCE OR CU SHORELINE OR ADBX INSPECTION 80 D 0
EQ'D POSTED ITI
[3 YES No
STATE LICENSE NUMBER
STATE LICENSE NUMBER
AUBURMI 163 B A 9/01/20 01
AUBURNI 1 63
kA
SERA REVIEW SIGN AREA HEIGHT
c. MPLETE EXEMPT ALLOWED PROPOSED ALLOWED , PROPOSED
3t
PROPERTY TAX ACCOUNT P,
PROPERTY TA ACCOUNT PARCEL NO- 4548-001-023-0002
-7
up M
LOT COVERAGE REQUIRED SETBACKS (Fr.) pnopoSED SETBACKS (FT.) C
FRONT BEIGE RI
I, M
-IX30M
FIESID PLUMBING I MECH
TI
:'AL X
ALLOWED PROPOSED FRONT SIDE BEAR
C] ADDITION COMM COMPLIANC OR
C 'AL E
0 X3( CHANGE OF UPIE
IRKING LbT AREA PLANNING AFVIMED BY_ DATE
VENT
T
0 REMODEL APART 0 sia'�
0
REDD I PROVIDED IT!
0 REPAIR CYDS 0 (FENCE X
r7l
IS
REMARKS
2
—
DEMOLISH [3 TANK o OTHER
�
C] RETAKININGWALL C] RENEWAL
0 GCA.F'124 'Go Y
0
_n
NSTMU Coo,,] OCCUPANT
(TYPE OF USE� BUSINESS OR ACTIVITY) EXpI_AIN:
ldi
ROup
M M
SP UIALEIDNSPECTOR JAREA7 LOAD
EEIC CCUPAN
LOAD a
R a R 0
N. BEIROF/�//
'� WELLING
jT'.RIES
ICAL
AREAS
UNITS _g
NUMBER
[3 YES
6
_
DESCRIBE WOR*TO BE DONE
REMARKS
INSPECTION REO'D
'.SP CT
OGRESS INSPECTIO NS PER UBC 10881
0
P and ixtures IA& 1 tA2� 1:4
VALUATION
Z
PLAN CHECK FEE
-04
HEAT SOURCE LOT SLOPE I BUILDING 0
0, ,-A c' 1711
Pj�" C;T N ED DATE P UNBIND
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS.WORK TO
IS E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE-PUBUC GRADINGIFILL
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
FICHARGE
t:
PERMIT APPLICATI�.'q() D
PERMIT UMIM I YEAR, PROVIDED WORK 11 STARTED WITHIN 1110 DAYS END, REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
11 OR EREP.U1E. IAEIFS.A�S�.IMSAN. SUCCEED FS END. INSPECTION FEE
OF
;Ap'P'L'E11�TjCAJ.EE1LF
N T BE F ES .N. MNIFY, DEFEND AND HOLD 14ARMLESS THE CITY LANDSCAPING
EDMOND%WA11INGTON IoTg.=�A�IS� EMPLOYEES. AND AGENTS FROM ANY AND INSPECTION FEE
F.FGAMAG Ly T
ALLCLAIM NATUR
e� E,ARISING DIRECTLYOR INDIRECT.,
OF THIS PERMIT. ISSUANCE 01 THIS PERMIT SHALL NOT PLAN CHECK DEPOSIT IRECII I
FROM THE ISSUANCE
9 DEEMED MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANyCTy.RoINANCE
To SIGN.- RECEI
TO ENFORCE ANYORDINANCf PROVISION
NOR LIMIT IN ANY WAYTHE CIW'S ABILITY
TOYAL AMOUNT DUE
THAT APPL ATION APPROVAL
IN HAVE READ THIS APPLICATION =oRM TION
AGCNTOF
G,:ERNEBY�=T�A`�GDIZATT: AM THE OWNER. OR THE DULY AUTH
U'I T , ppi,c I_ i, �.j . p.1 b�bl ,glld by ine
A,'.R" PLY WITH CITY AN D STATE LAWS REGULXT'N.IoNSTRuC- CALL B dl'90fl,,.iolhl�,,Dlplty:a.dFO46alc,.,�..�,I
TH' o � TE.'EoWC..MK AUTH OR I 11. THI ERE BY, NO FEE B SON WILL BE EMPLOYED
STATE OF WASHINGTON RELATImG TO NSPECTION 11k,,d9.p.. F—IdId.
T , =R FOR I
IN Vi*6LATION OF THE LABOR CODE OF THE
WORKMEN S CqMPENSATION INSURANCE AND RCW 18.27. Rp VSGN
DATE SIGNED (425)--
Sj;V�,qArj)jijj 4OW Ej��
I
771-0220 1 IJATE
EXT1333 (3
�
ATTENTIW
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771 -Q221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI ORIGINAL FILE YELLOW' SIECTC
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR
5,98