20010621.pdfPERMIT EXPIRES
US' P
CITY OF EDMONDS
ZONE
'08 SUITEIAPT.
CONSTRUCTION PERMIT APPLICATION
ADDFESS
PLAT NO
LOT 10
LID NO,
LID FEE 5
WILING ADDRESS
PUBLIC RIGHT OF WAY PER OIIICI�L STREET MAP
EXISTING — PROPOSED—
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CITY
REQUIRED DEDICATION— FT
NAME
METER SIZE
LINE El;�'�OF
FIXI�S
P V REOUIRED
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ADDRESS
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OWNERIGONIRACTOn RESPONSIBLE I.R IIPOEIG� CONTIOICRAWAGE
TELEPHONE
NAME k�l
TANK Fil
-MOVAL, OR CAP I
1- gP
ENGINEERING
REVIEWEDIDATE
C ADDRESS
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FIRE REVIEWED BY
DATE
CITY ZIP
TELEPHONE
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VARIANCE OR CU
SHORELINE OR ADB4
INSPECTION
REDO
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BOND
POSTED
STATE LICENSE NUMBER EXPIRATION DATE
R(- co c lew�r R
I CHECKED By
SEPA REVIEW
COMPLETE I EXEMPT
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SIGN AREA
ALIOWID I PROPOSED
HEIGHT
AL OWED 'Ropo...
PROPERTY TAX ACCOUNT PARCEL NO.
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C] NEW RESIDENTIAL 0 PLUMBING f MECH
LDTCOVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS IFt)
FRONT SIDE REAR
PROPOSED SETBACKS (P-0
FRONT UPSIDE REAR
0 ADDITION C] COMMERCIAL COMPL ANCE OR
CHANGE OF USE
PARKING
L.TAREA _rNING
REVIMED By DATE
F] REMODEL 0 APARTMENT SIGN
RED D
I PROVIDED
0 REPAIR C] GIAOING �YGE 0 'IENCE
REMARKS
DEMOLISH �TAN 0 . IHER
G R G4 FOC F.2 WALL E3 RENEWAL
C CA A RETAKIN
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P (TYPE OF USE. BUSINESS OR ACTIV
GRECKEDBY
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I NUMBER
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UNITS
C R ITICIL
AR EAS
NU NEER
SP UA
C] YES 0GE"A",
R EEQC RLEIDN5PECTGR JARIA LOAD
DESCRIBEWORK TO BE DONE
W— , N,
,�4ttA eve,
REMARKS
PROGRESS INSPECTIONS
PER UBC 108/FINAL INSPECTION REO'D
Fill Al�?
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE GLAZIN. I LOT SLOPE %
BUILDING
PLAN CHECK NO: TED DATE
PLUM51NG
MECHANICAL
THIS PERMIT AUTHOR IZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONST, RUCTION ON THE PuBU c
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS . MARQUEES. ETC.) WILL REQU ME
SEPARATE PERMISSION.
RA IN.,
rGRADINGfFILL
��FCHARGE
PERMIT APPLICATION: NIB AS
PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. REVIEW FEES
'A 'APPLICANT. ON BEHALF OF HISOR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
AMLESS THE CITY OF
N INTER: T. AGRE EFY. DEFEND AND HOLD HARMLESS THE CITY OF
I DAOND WASHINGTON. IT OFFICIALS. EMPLOYEES, ANDAGENTS FROM ANYAND
ILLCLAIMS FOR DAMAGES 0 WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
R M THE ISSUANCE OF THI PERMIt ISSUANCE OF THIS PERMIT SHALL NDT BE
o
DEEMEDTo MODIFY, WAIVE OR �EDUC EANY REOUIREMENT OF ANY CITY ORDINANCE
N ENFORCE ANY ORDINANCE PEQllllCN..
OR LIMIT INANYWAYTHE CITY SABILITITO
IN.. INSPECTION FEE
LANDSCAPING
FINSPECTION FEE
PLAN CHECK DEPCSIT
TOT L U 0 N T DU
TOTAL AMOUNT DUE
RECEIPT
IHERED Y ACKNOWLEDGE THAT I HAVE READ T�ISAPPUCATION. THAT THE INFORMATION
GIVEN IS CCRRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THEO,NNEA $AGREE 70 COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
TION. AND IN DO NO THE WORK AUTHORIZED THEREBY. NO IERSONWILL BE EMPLOYED
IN VOLAT 1 0 OF THE LABOR CODE OF THE STATE 01 WASHINGTON FELATING To
CALL D I, F — F
. . . ., A_�_ P _�. _,._
FOR INSPECTION
WCPK.ENSC011FAT INSURANCE AND RCW 1821
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(42,15)
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ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
A FINAL IN S PECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
ORIGINAL FILE YELLOW INSPECTOR
PINK OWNER GOLD -ASSESSOR
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Filco Company Inc. Lic, # FU-COCIO80RU EXP. 10/10(o
P.O. Box 31228 IFCI License-adw-13--o 3—
Seattle WA 98103 City License#_,
206-547-8347
OB SrrE ADDRESS: &-akw'A 46ME
OWNER: qIf;AIVF1? Ef%7-0 CXit - MW
ADDMS, g.41n P-
PHONE: �42 A�J-4 IJM MfA[,;V3.,1
wepla and Fill)
U9 �—Y yuretbane oam.
Pump & clean ow.30 gallon underground oil tank. Fill with StructUld Pot F
cut off or remove vent and filler pipes and cap them permanently bet— grade.
(pump Clean and Cap)
Pump & clean one gallon underground oil tank. Cut off or remove vent and filter Pipes
and cap them permanently below grade
0(p
.emoaj)
pump out one gallon underground oil MnIL Excavate and remove tank then back fill hole
and dispose of tank in proper manner.
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TO: —
DATE:
IVIEMO TO: P7EV IN Top, BUILDING DIVISION
FROM: FIRE DE PARTNEENT DATE,
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE—
PROJEC
SITE ADDRESS-
pERmrr#--L&—Q1-L�(,2- —ADB#-----DATEINsPEcTFI)
DESCRIPTION OF WORK TO BE IRWNSPE L)5Tl- 86�60A,(-M
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of:
�Final approval of the described work
iated with the project may be released
Bonds assoc
_,.�—GRANT FINAL �ROJECT APPROVAL ' osi)
_GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
___--YAILED FINAL INSPECTION - OUTSTANDINdISSUES
1.
2.
3.
_______jtE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvl.doc.l:t��:bldg:forms6/98
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
.�SETB��IKS
FOUNDATION:
Footing ...........
Wall ..........................
PledPorch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final
HEATING:
GasTest ....................
Gas Piping .................
EqUIPMOnt 4
commercial Final 0...
EXTERIOR SHEATHING
NAILING ............... ; ..........
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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DATE RECEIVEDe/,
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER N MEINAME OF BUSINESS
C III': ". "t-'n g::,<- T. -r,':!' W.4 72
MAILING ADDRESS
ZIP P=
ADDRESS & I /
CITY ? �l ]TELEP ��'E
NAME IC;l
C
CIT ZIP TftSPHON�
':�* 4
_)t a 1/6 V/, I 2o,(- ,�40 -Al 41 7
STATE LICE BE NUMBER
,51-t ra r / a E,� mh�
0 NEW
4 RESIDENTIAL 0 PLUMBING I MECH
0 AUDITION
0 COMMERCIAL o COMPLIANCE OR
CHANGE OF USE
0 REMODEL
0 APARTMENT 0 SIGN
0 REPAIR
0 FACING C'.S 0 FENCE
F_I
OTHER
0 DEMOLISH
)(—K o
0 CARA '
GARPORT
0 RETAININGWALL
— ROOKERY
0 RENEWAL
NUMBER
1111IR
IICA
0
DWELLING
UNITS
AREAS
NUMBER
MIT AUTHORIZES ONLY THE W RK NOTED. THIS PERMIT COVERS WORK T
THIS PER 0 V C
BE DONE ON PRIVATE PROPERTY ONLY. AN CONSTRUCTION ON THE PUBLI
GOMAIN (CURBS. SIDEWALKS. DRIVEWAYS ARQUEES. ETC.1 WILL REQUIRE,
SEPARATE PEZISSION
PERMIT APPLICATION: IBODAYS
PERMIT LIMIT. I YEAR . PROVIDED WORK IS STARTED WITHIN 16D DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
;APPLICANT. ON BEHAL OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESOR
IN INTEREST. AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE Clly G
I EDMONDS,WAIIII�I.ITOI TFS�.FF�.IAL�..MILOYEE�.�ND�.E�T�IROM ANYAN
X VIER ATURE, ARISING DIRECTLY OR INDIRECTLY
ALLCLA'M FORD GE,G HATE IN
MIT. S UANCE OF THIS PERMIT SHALL NOT 8
FROM THE ISSUANCE OF THIS PER S 'EOUIREMENTOF ANY CITY ORDINANC
DE'ME.T. GGIFyWA.E OF REDUCE Ahl�
N -" 1 PERMiT EXPIRES
i6�E P
'50 PERMETpQ&
NUME,
'OB SLI111AIT'
ADDRESS A /,I"
�?,' _ X_
PLATNAM�tBDIVIMNNO.
LOTNO.
LIDNO
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
'—w— u
PIZ
1441 103
EXISTING — PROPOSED �—
M. =1
l.=. RR-�' [03
Am UIRED DEDICATION— FT �
wu="=.
METER SIZE LINE SIZE
NO.OFFIXTURES
PRV REQUIRED
U
I I
YES 13 NO 0
3
I
REMARKS
RESPONSIBLE FOR EROSION CONTROUDRAINAG9
OWNEFdCONTaLCTOR
VIALMARSHAL--
FrK
E _NT FOR
5 11 PRIE
'70
'MOVAL OR CAP
t
I fftMoVo
A K Fl L,
ENGINEERING .... EDIDATE
IF REVIEWED BY DATE
VARIANCE OR CU
SHORELINE OR ADO#
INSPECTION
REO'D
IPSOND
STED
tFIRS
0 VES ONO
SEPA REVIEW
C COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED , PROPOSED
P I
EXP
LOT COVERAGE
REQUIRED SETBACK$ tFT)
PROPOSED SETBACKS (Fr.)
AIIOVIED PROPOSED
FRONT SIDE FEAR
FRONT URStDE REAR
PARKING
IR!Y DATE
REDD IFIOV iDED
k
I
Ks—
CHECKEDBY
FRUCTION
11C D OCCUPANT
ITYPEr
GROUP
TOR
OCCU T
JAREA
REQUIRED YES
E]
LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC i0afFINAL INSPECTION REO'D
VALUATION
FEE
PLAIN CHECK FEE
MECHANICAL
0
GRADINGIFILL
VrATE7SbRCHARGE
ENO. REVIEW FEES
s ENO. INSPECTION FEE
I. LANDSCAPING
0 INSPECTION FEE
CEIPT
E
E
0 NORUMLT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANYORDINANCE PROVISIG,
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READTHIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE OULY AUTHORIZED AGENT
OF
THE OWNER I AGRE E TOC MPLYWITHCITY ND STATE LAWS REGULATING CONSTRUC
THEREBY. NO PERSON WILL BE EMPLOYED
CALL
TlON; AND IN DOING THE WORK AUTHORIZED
IN VIOLATION OF THE LABOR CODE 0 THE STATE OF WASHINGTON RELATING
TO
FOR INSPECTH
WORKMEN S CO:��IONI INSURANCEANDRCW 1&27�
SjGNAT4PK'jftNE
/
(425)
771-0220
EXT 1333
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
B."_0 0146.1 ol hi�.' .,d F .. F.W.. .�d
_t IF .�k'.�pd.n p.. p—W.'! j I
DATE
ELEA$E GAT
ORIGINAL -FILE yE,,GW mlPECTOR X
PINK - OWNER GOLD - ASSESSOR
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