20010647.pdfP, U0 C5,
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OW 11"A�IANIMEOFBUSII IS
H. A. S. C. 0.
MAILING ADDRESS
12625 4th Ave West, #200
0
CITY ZIP TELEPHONE
Everett 98024 425-290-8499
CITY
NAME
Cornerstone Roofing, Inc.
ADDRES
20611 Both-Evt HWY #152
CITY ZIP TELEPH NE
Bothell 98 01 2 425-485-0111
STATE LICENSE NUMBER EXII-1 --N —1
CornerIollcm 2/02 11
U.EE PERMIT Z _6W
'ON RM1.5 NUMBER "�Vj
jos SUITEJAPT4
ADDRESS 23326 Edmonds Way
FLAT NAMUSUBDIVISION NO. I LOT NO. LID NO.
LIG FEE I
PER OFFICIAL STREET MAP d
P1.11. *RIK I
EXISTING — PROPOSED�
REQUIRED DEDICATION— FT — U-m—
.ETERSIZE I LINE 1111 1 NO-011IXTURES P- REOUIRED
f R MARKS _1 YES 13 NO 0
.t1HT1.R REIP.NBI.LE FOR EROSION C.NTR..DPAl..E
FIRE REVIEWED By
DATE
0 YREO-D I P05TIl
Ad. n Ap ES [XING
E; HEIGHT
SERA REVIEW A.N A T
COMPLETE EXEMPT AU.0Yi1:D PROPOSED ALLOWED , PROPOSED
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LOTCOVEFIAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (17.)
'L UMBN G M CH
0 NEW 0 RESIDENTIAL 0 PLUMBING I MECH
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ALLOWED PROPOSED
A 11-o PROPOSED
E A R
FRONT SIDE REAR
FRONT
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0 REMODEL 6 APARTMENT 0 SIGN
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AR
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0 DEMOLISH 0 TANK ZLr'oof
0 1 t p
Wood shake to asphaltj approx same
color.
AR RETAINING WALL 0 RENEWAL
AGE EW
CAR OFT
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(TYPE OF USE. BUSINESS
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u NITS
NUMBER
REOL NEIDNSPECTOR
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1
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
RE R C IN L,
. . .PE ER UBC 108/FINAL INSPECTION REO
P p. . . I CT... PER
ROGRESS INSPECTIONS P
Edmonds H' ghlands
Remove shake roof, Install 40-year
comnosition. Already has a solid
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VALUATION I FEE
PLAIN CHECK FEE
=!:��T
110111
BUILDING
PLAN CHEC���
�VESTED DATE
PLUMBING
MECHANICAL
THISPERMITAUTHO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTFIUCTIONON THE PUSUC
GRADINGIRLL
DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS, MAROUEES. ETC.) WILL REGUIRE
SEPARATE . PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION 11� DAYS
PERMIT LIMIT'. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
HES OR HER SPOUSE HEIRS. ASSIGNS AN SU ES I
ENG, INSPECTION FEE
T IN. MNIFY. DEFEND AND HOLD HARM] E I THE ITY F
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UEGUIREMENT
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PLAN CHECK DEPOSIT
Y ANY OF ANYCITY ORDINANCE
DEE.E F EDUCE -
PROVISION
AWA,�E..
NGFU.,T IN ANY W Y I ABILITY To ENFORCE ANY ORDINANCE
THE CTy�
TOI AL AMOUNT DUE
H.,EPT
DO E THAT I HAVE READ THI I AP PLICATION HEINFOF.ATION
P LICATION APPROVAL
,ER _,THAT
I H EREBY ACKNOWLE
GIVEN IS CORRECT. AND THAT I AM THE OW1
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AND ED THEREBY, NO PC LATILOYTO
T'.N IN DOING THE WORK A IZ -RSON WILL
OF WASHINGTON RE NG 0
FOR INSPECTION
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IN VIOLATION OF THg.- g ATN.E STATE
T URA W 10.27,
'A�WORKMEN S
OF I IAL IGNATUR
FO�
(425)
SIGNATUPE,OE,(�� 7=
771-0220
LEASED By
EXT 1333
ArrENTIO
IT IS UNLAVA'OtTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL NSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OFIOCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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CITY OF EDMONDS ZONE NUMBER
CONSTRUCTION PERMIT APPLICAT16N jos SUITUAPT.
ADDRESS 23326 Edmonds Way
OWNER NAMEINAME OF BUSINESS
H.A.S.C.O. PLAT NAME/SUBDIVISION N L o.
,�D N S
D FEE
6 MAILINGADDRESS
12625 4th Ave West, #200 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
P
Q o
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CITY zip EXISTING - PROPOSED o
1180 TEL PHONE a
Everett 24 425-290-8499 AFOUIRED DEDICATION- FT
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NAME - METER SIZE I LINE SIZE I NO.OFIIKTUIES PRY RIOU19ED
YES 13 NO
ITT
ADDRESS R MARKS DRAINAGE
OWNERICONTRACTOR RES
FONSIBL FOREADSIONCONTROU
CITY zip ITELEPHON1
NAME
Cornerstone Roofing, Inc.
ADORES
20611 Both-Evt Hwy #152
CITY zip TEIEPH NE
Bothell 98012 425-485-0111
STATE U ENSE NUMBER EXPIRATION DATE
CornerIollcm 2/02
�s
ENGINEERING �_AEVIEV45DIDATE
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0
FIREREVIEWE ATE
-
0
OMFLE
Im
M
VARIANCE OR CU SHORELINE OR ADBIT
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SERA REVIEW SIGNAREA
COMPLETE EXEMPT ALLOWED PA POSED
HEIGHT
ALLOWS PROPOSED
12
K . . . . . .
E p
RID
0
BIN ECH
P LuM M
0 NEW RESIDENTIAL 0 PLUMBINGIMECH
R"
LO COVERAGE REQUIRED SETBACKS (FT)
F1
ALLOWED PROPOSED FRONT SIDE REAR
PROPOSEDSETBACKS (17.)
F�ONT UPSIDE REAR
0
C MPLIANCEOR
L ANCE R
o P I
M M
ADDITION COMMERCIAL CHANGEOFUSE
C3 ci A t E OF USE
PARKING
REGO PROVI ED
LOT AR EA
JPLANNINGREVIEVEDSY DATE
N
0 REMODEL APARTMENT 0 SIG�
GRADING FENCE PT,
b
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A AK
pYDs t X
, _x _FT)
C] DEMOLISH 0 TANK OTHEROO,
I rero_
0 -n
"n
Wood shake to.asphalt, approx same
to
DAMAGE RETAINING WALL RENEWAL
CARPORT 0 gpoKEPY
m T
0
0 0
color.
(TYPE OF USE, BUSINESS OR ACTIVITY EXPLAIN:
Aba(rtment
CHECKED BY
Y 0
F C
JTZ!:N�
1
OCCURA T 4
r
'ROUP
NUMBER
o F
OF CRITICAL
NUMBER,
ARE.
DWELLIN 8 bldgj EAS
SPECIAL NSPECTOR
REIG
JAREA OCCUPANT
LOAD
B TORIES
UNITS UMBER
�gU
R OU
RE UIRED YES
, _ I [:] YES
K 0)
M
DESCRIBE WORK TO BE DONE , - I ) I
Remove shake roof, install 40-year
momposition. Already has a solid
.0 1
1 -
Z
REMARKS
PROGRESS INSPECTIONS PER UBC 1081FMAL INSPECTION REO'D
Z
Edmonds Highlands
VALUATION
FEE
PLAN CHECK FEE M
HEAT SOURCE GLAZING I
LOT SLOPE
BUILDING
PLAN CHEC
1111TED DATE
PLUIVEIMI
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVER WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU BLIC
GRADINGIT41.1.
3
DOMAIN (CURSS, SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REaUIRE
STATE SURCHARGE
3
I=
SEPARATE PERMISSION.
PERMIT APPLICATION! ISO DAYS
I
PERMIT LIMIT. I YEAR - PROT11DED WORK 15 STARTED WITHIN 1110 DAYS
ENG. REVIEW FEES
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
I
'APPLICANT ON I AL F H�JR HER POUSI_ H�IRS, ASSIGNS AND SUICE SOPS
EKG, INSPECTION FEE
IN NTEREST .. N"Y E FEND AN D HARM �55-jft CITY Ul
NA FROM ANY AND
LAND C FIND
E EMPLOYE%,9ALNOAGEN
0 ... B .�TSKT. "C'ALS
AI.LCLAIMSFORDAMAGES OFWKATEVER NATURE, ARISING D - -�OT-��
; INSPECTAION FEE
ER��J� 5�7
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS P L
PL AN CHECK DEPOSIT
I
, DEEMEDT=1YWAIVEOR I11OLICEA4Y REQUIREMEITOFANYCITYORDIIIANCE
0 NORU.'T WAYTHE CITY SABILITYTO ENFORCE ANYORDINANCE PROVISION.
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE 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 REQUI-ATING CONSTRUC,
CALL
TION. AND IN DOINGTHE WORK AUTTIORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLAIIO���� THE STATE 01 WAININGION RELATING TO
FOR INSPECTIC
WORKMEN'S AND RCW 18.27.
SIGNATURE TOWNE
(425)
e_ 1
771-0220
ATTENT133fi
EXT 1333
IT IS UNLAVVI`!9L TO USE OR OCCdPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX'
5,98
q�PWY: .�d F..t,. OWd. r,d
PINK OWNER GOLD ASSESSOR