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20010609.pdfAECEIVED_,// 46101 PERMIT EXPIRES &9 ILI ZONE CITY OF EDMONDS 80— CONSTRUCTION PERMIT APPLICATION lAoWl R... z4h IL I SUITE/APTS CITY NAM DO CITY CITY rt- 4aC 50 ZIP I TELEPHONE -7 76p ZIP I TELEPHONE R%�W TAX ACCOUN PARC NO. NEW PLUMBINGIMECH ..IT' C] 7A COMPLIANCE OR CHAN EOFUSE 0 REMODEL 63".IGN REPAIR 11 GRADING CYDS FENCE cl ( X FT) DEMOLISH 0 TANK OTHER oGARAGE C Po AR RT 0 R ]NINO WALL ROCKPRY C] RENEWAL (TYPE OF USE. BUSINESar�TIRX_ %od NUMBER CE"CA, OF CUMILIL", AREAS STORIES UNITS UMBER DESCRIBEWORKYOSEOME I I V) c� PLAT NAME�SUBDIVISION NO. I LOT NO. LID NO - LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP R,0 I le— ll� d EXISTING — PROPOSED — REQUIRED DEDICATION— FT METE"ZE LINE SIZE NO.OFFIXTURES P V REQUIRED I YEE C3 .0 0 ow —,--ma mr-n—m F FOR EROSION OONTAOUDRAINAGE_ FIRE REVIEWEDBY DATE VARIANCEORCU SHORELINE ORIU�b- INSPEC ION SC ol_ ( RIO'D POE YES 0 NO SEPA REVIEW SIGN AREA HEIGHT ... FLUE B.—I ALLOWED I PROPOSED 2Z41 Ze, -fII, 'LL* I �P I P '12plo REQUIRED SETBACKS (FT.) PROPOSED SETBACKS ALLXI;� FRONT SIDE REAR UR SIDE RE P�7jED 0 �( 0( 7 , 9f _2 PARkING LOTARFA P ATE 742 _ -7-3 I .41 CH KEDBY ITYP,7&yj--N ..... F.MP IIECIALINSPECTOR JAREA ODADURANT REQUIRED E] YES Lo PER UBC VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING LOT SLOPE % I ' BUILDING P LAN CHECK NO: E.TEG DATE n\ r , PLUMBING M 58UILDN MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL L . DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION, —SURCHARGE B PERMIT APPLICATION: 180 DAYS PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SIEEBAOKO PINK PERMIT FOR MORE INFORMATION S. S . SUCCES FE 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS FEE ENG. INSPECTION FEE IN INTEREST. AGREES TO IND MNIFY. DEFEND AND HOLD HARMLESS THE CITY F ECIFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND LANDSCAPING INSPECTION FEE EDMONDS. WASHINGTON, ITS DIR ALLCLAIMSFORDAMAGESOF WHATEVER NATURE.ARISING ECTLYORINDIRECTLY JAECIT FRO. THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SMALL NOT BCE ANY CITYORDINAN PLAN CHECK DEPOSIT DEEMED MODIFY, WAIVE OR REDUCE ANY REOUIREMENTOF NOR LIMITT ON ANY WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- TOTAL AMOUNT DUE jRECEIzf&9 I HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT. AND THAT ANI THE OWNER, OR THE DULY AUTHOR ZED AGENT OF : COMPLY NTH CITYAND STATE LAWS REGULATING CONSTRUC- CALL T., 11,01 11 It a pl—t 11111 llglld tq the THEOWNER. I AGREE TO TION. AND IN DOING THE WORK AUTHORIZED THEREBY, No PE N WILL BE EMPLOYED REGOTON Bu.Id..9 Onppe',al w heft, Dopty: �d Fee, — p-, .d IN VIOLATION OF THE LABO CODE OF THE STATE OF WA SHIN RELATING TO I- OR INSPECTION p ackno.kx1ged 11 p,w p—ded WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27, OF I S SIGNATUR DATE IZEI]�) (425) ;I.N.UFE kSIG.EO 771-0220 RnE BED BY 1AT)f W77ENTibN EXT 1333 IT IS UNLAWFULTO USE OR OCCUPY ABUILDINGOR STRUCTURE UNTIL 771-0221 A FINAL INSPECTION HAS BEEN ADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 FAX PINK - OWNER - GOLD - ASSESSOR z 0 4 C3 M a M 0 rn� 0 -n m M gas 6 Fn c m 0 z 0 0 m FINAL PRO CT APPROVAL FO TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: —FIRE DEPARTMENT DATE — ENGINEERING DIVISION DATE — PLANNING DIVISION DATE--L-23 --OQ-- PROJECT— SITE ADDRESS DATE INSPECTE PERMIT D DESCRIPTION OF WORK TO BE INSPECTE A field inspection was conducted to determine final compliance with approved plans. Final approval denotes that there are no objections from the above signed Department to the release of PER RMANCE BONDS and the granting of: GRANT FINAL PROJECT APPROVAL GRANT PROJECT APPROVAL WITH CONDITIONS NOTED a Copy of CONDITIONS given to owner/contractor by inspector 1. FAILED FINAL INSPECTION - OUTSTANDING ISSUES u Copy of CORRECTION NOTICE given to owner/contractor by inspector 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Sign_ ocaprvl.doc.l:temp:bldg:fonnslO/oI z 0 Z4 0 M =1 �n Fn -4 0 x C rn M 0 __10 00 C: -4 C 3: M M z jo -i C: 2 > o'n 4 = 3: M M 055 0 0 C M Z z __4 z 0 i 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: o Footing ................ Wall.......................... Pier/Porch ................. Retaining Wall ........... Slab insulation .......... PLUMBING: Underground ............. Rough -in ................... . Commercial Final HEATING: GasTest .................... Gas Piping ................. Equipment................ io" Commercial Final EXTERIOR SHEATHING NAILING ................ t FRAMING........................ FIRST FLOOR FRAMING. INSULATION ................... Floor insulation Wall Insulation ........... Coiling Insulation SHEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. 0, M I 0M TR M Fn 0 Z 0 rn _j L RECEIVED, FPERMIT EXPIRES Ull ME PERMIT CITY OF EDmfflbs CONSTRUCTION PERMIT APPLICATION '0, ADDRESS 4" ke, 3 OWNER NAMEANAME OF BUSINESS :.7- 1) 00 PLAT NAME;SUBDiVISION NO. I I -NO. 111) NO, A. c LID FEE $ 0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP ,d WP,.R A q.k.d E.... P.. A� d CITY E ISTING— PROPOSED— —.1 13 REQUJREDDEDtCATION— FT — --NAME METER SIZE LINE SIZE NO.OFFIXTURES PRV REQUIRED '1 Al I YES C3 No 0 ADDRESS REMARKS OWNE..NT.A.T.. RESPONSIBLE FOR EROSION C.HT.....Al— Q FIRE REVIEWED BY- DATE CITY VARIANCE CROU 1 SHORELINE Oijj� 01-(01, INSPECTION 'BOND OSTtt STATE LICENSE NUMBER EXPIRATI—AT, CHECKED By SERA REVIEW COMPLETE I EXEMPT EXP ION AREA ALLOWED PRO ALLO PRIO;FED L NO. eNEVY 0 RESIDENTIAL P UMBING I MECH ADDITION C MPLIANCE R O'COMMERCAL C ANGE OF USE C] REMODEL APARTMENT 0 9 REPAIR ORADING CYDG 0 I"NCE X FTI OT I AL;�� P / �7jEo l.AlKE IFTJ FRONT SIDE 95 ;d- PROPOSED SETBACKS IFl: FF, W�RDE 7 PARkING RE LOT AREA fATE Pp E�;/ -REMARKS 'C3 DEMOLISH TANK [3 OTHER ciGARAGE RETA.INING WALL RENEWAL CARPORT .0 Y 0 (TYPEOFUSE. BUSINESrACTIMLAIN: I% 01 -L q CHECKED ��YJICTION 0 CUPANT GROUP NUMBER OF IN LIVE DID DW.LLIW. FI Al - CRT" A EA ... S R E SPECIAL INSPECTOR 111EA REOU 0 IRED YES OCCUPANT LOAD _STORIES DESCRIBE WORK TO BE DONE REMARKS PRnrRFSr INSPECTIONS PER UBC 108/FINAL INSPECTION REO' VALUATION FEE PLAN CHECK FEE HEATSOURCE GLAZING % LOT SLOPE I BUILDING PLANCHECKNO: DATE PLUMBING MECHANICAL _L:ED THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC OMAIN ICURBS, SIDEWALKS. DRIVEWAYS , MARQUEES, ETC.) WILL REQUIRE SEPARATE PER�ISSION. GRADINGIFILL PIRMITAPPLICATION: 1110DAYS PERMITLIMIT.1 YEAR -PROVIDED WORK IS STARTED WI HIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION END, REVIEW FEES ENO. INSPECTION FEE 'APPLIOANT, ON BEHALF OF HIS OR HER SIOUSE, 11IR5, ASSIGNS AND SUCCESORI IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY UF EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM, ANY AND ALL CLAIMS FOR DAMAGES OFWHATEVTERINXTURE. ARISING DIFECTLYOR INDIRECTLY FROM THE ISSUANCE OF THIS =iA SSUANCE OF TH.' ' --7MIT SHALL NOT BE 9 DEEMED TO MODIFY, WAIVE OR NY REOUIREM ENT OF ANY u;-Y ORDINANCE NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFO RCE ANY ORDINAN�E P.OVISION.- LANDSCAPING INSPECTION FEE PLAN CHECK DEPOSIT RE122 I - li2 TOTAL AMOUNT OU ECE7 I HEREBY ACKNOW EDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION GIVEN IS CORRECT, AND THAT I Am THE OWNER, OR THE DULY AUTHORIZED AGENT OF THEOWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO CALL FOR INSPECTION APPLICATIOU APPROVAL TN. .,p',. �Y P1 1. .�kmM.dg.d I. P.. pl.lftd. OF IALS SIGNATURE DATE W, lal-9k, WORKMEN'S COMPENSATION INSURANCE AND RCW 10 27, (425) 1 771-0220 �AOENT) SIGNATURE (C�NER(:� S GNEO RE SEDBY DATjf / ' ATTENTION EXT 1333 F IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 oljyjl� -, 4 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIG$NAL-FILE YELLOW-] PECT R CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OMINER COLD - ASSESSOR 5,95 z 0 Om a M 0 0 C) c jr '.. m ID z 0 -n m m a 0 0 Fn c z 0 m