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20010652.pdfDATE RECEIVED q-,� -,g/ FPERMIT EXPIRES CITY OF EDMONDS ISEE -2 L_b PERMIT ON "MER)X)A6 — CONSTRUCTION PERMIT APPLICATION IOBRESS J+V K�f SUITEIAPT. ADD OWNEX�N;:,OF 8�� PLAT NAMUSUBDIVISION NO. LOT NO, L MAILINGADDRESS Jo Aw A),. L�DN DFEES PUBLIC RIGHT OF WAY PER (31RCIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT TEI�I:AIX,1111 0 RW 17: "1"" 0 .... P.—A" 0 lA.q1 0 S... '� II.1-d CITY ZIP TELEPHONE NAME METER SIZE I LINE Sl�� NO. OF FIXTURES PRV REQUIRED I Y S 13 No ADDRESS R MARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAII—E CITY ZIP ITELE'"ONE FIRE MARSHAL NAME MUST BE PKI:bt:N 1 m 08 ENGIN-TANK tMIJVt%�, -ILL, _R I-IIEVIMVIDATE ADDRESS 1pggp FIRE REVIEWED By DATE CITY ZIP TELEPHO E 0 16 ST%ICE SJE,�BER EXPIR.A11,014 DATE VARIANCE OR CU SHORELINE OR ADBN INSPECTION 0 YRE 'D ES E3NO BOND POSTED SEPA REVIEW COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALL WE. PROPOSED PROPERTY TAX ACCOUN FUEL NO. U ?7- 4ZZ5.," EXP I , 0 NEW RESIDENTIAL C] PLUMBING I MECH VERAGE ALLOWETIC' PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED ETBA KS (FT.) FRONT. USRSIDECREAR C3 AUDITION COMMERCIAL COMPLIANCE OR 0 CHANGE OF USE 0 A�RARTMENT 0 SIGN REMODEL cl PARKING REDD I PROVIDED LOT AREA I-ANNING REVIEWED BY DATE E] 'FENCE 0 REPAIR C] GRADING CYD. X FT) _rE DEMOLISH TANK C] OTHER GA RAGE RETAINING WALL RENEWAL CARPORT PIUCKER, C] (TYPEOFUSE.BIUSINE74rl IEIPILAIN: CHEGKEDBY ITIPE JCODE OCCU PA P M NUMBER 0 OF IS 0 STORIES NUMBER 01 D WELL NO UNITS CRITICAL A=R N�STJTION ?AC.�A PANT DESCRIBE WORK TO BE ONE REMARKS PROGRESS INSPECTIONS PER LIBC 1081FINAL INSPECTION REQ'D 7�3 69Ql At^' 41-& VALUATION FEE PLAN CHECK FEE HEAT SOURCE LOT SLOPE % BUILD'.. PLA IVESTIO DATE PLUMBING MECHANICAL THIS PERMIT AUTHO IZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO - N H P BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTIO ONT E UBLIC GRADING/FILL U DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL RED IRE SEPARATE PERMISSION. P MIT APPLICATION: ISO DAYS ER "_�SUFICHAF.E PERMIT LIMIT: I YEAR PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION ENG. INSPECTION FEE 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS HE CITY OF LANOSCAP NO U EDMONDS, WASHINGTON. ITSOFFICIALS. EMPLOYEES, ANDAGENTS FROM ANY AND AULCLAIMSFOR DAMAGESOFWHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY INSPECTION FEE RECEIPT FRO THE ISSUA CE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE EEMEDT0 MODIFY.WAIVEOR REDUCEANY REOUIRE.ENTOF ANY CITY ORDINANCE PLAN CHECK DEPOSIT 0. NORUMIT INANYWAYTHE CITY S ABILITY TO ENFORCE ANY ORDINANCE PROVISIO CEIPT 7— TOTALAMOUNTDUE IR / IHERE Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION . APPLICATION APPROVAL GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DUL`f AUTHORIZED AGENT OF THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL T ION� AND IN DOING THE WORK AUTHORIZED THEREBY, No PERSON WILL BE EMPLOYED d!n9'..,.P,Ior ep.1y:-d F ,, d. �d IN VIOLATION OF THE LABOR CODE OF THE STAT E OF WASHINGTON RELATING TO FOR INSPECTION 1. .0-11,191d � IP w P—dDd. WORKMEN S COMPENSATION INSURANCE AND ACW '82, ATURE DATE SIG]]2�� DATE EIG ED (425) fgss,� j 7_1 I-W-0 RELEASEDIfy OATE' ATTENTION v EXT 1333 IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-nggl A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELUOW- INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR "B 3<11 z 0 4 0 m -i -n ai � 0 m c 0 m 0 80 c � c m '0 c Of MITI a v; 0 o Fn C C,7 0 z co z 9 0 m WEI a W Mill 010 W.W.9 a 0100 DATE: MEMO TO: P DING DIVISION FROM: IRE DEPARTMENT DATE 7' ENGINEERING DIVISION DATE — PLANNING DIVISION DATE— J/ SITE ADDRES PERMIT # AD ------- —DATE INSPECTED- 13# DESCRIPTION OF WORK TO BE INSPECTED (2-57 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 erformance Bonds associated with the project may be released �ROJECT APPROVAL GRANT FINAL _GRANT FINAL PROJECT APPROVAL wrrH CONDITIONS NOTED __FAILED FINAL INSPECTION - OUTSTANDING -ISSUES 1. 2. 3. ____--RE-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL ocaprvi.doc.l:temp-.bldg:forms6t98 z 0 0 C: M M 0 0 C M M Z z o -n n M M 0 0 0 M C (1) 9 CD M 0 Z z Cl) z 9 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: 'Footing ....................... Wall.......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -In ................... Commercial Final HEATING: GasTest .................... Gas Piping ................. Equipment ............. commercial Final EXTERIOR SHEATHING NAILING .......................... 'FRAMING ............ ........... FIRST FLOOR FRAMING.... INSULATION ................... Floor Insulation Wall Insulation ........... Ceiling Insulation SHEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY ................ Z. to) M rn M C Z 0 -n n Wr 02 Z� ECEIVED FPERMI EXPIRES CITY OF EDMONDS ZONE SUITUAPT, CONSTRUCTION PERMIT APPLICATION 'AoD5DRESS U 0(� V �2 Vd OWNEKE'NeAM"/0F BUSINESS PILAT NAME/SUBDIVISION NO. I LW No. L No. "IC t -:!6-&.4192— L�ID) FEE S MAILING ADORES PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP A- F..N. EXISTING — PFIOPOSSD� 13 CITY REQUIRED DEDICATION— FT -d 0 0 PRV REQUIRED NAME YES 0 NO 0 AIIIAAA�. M ADDRESS .-P-1-F FDA EROSION CONTROUDRAINAGE FIRE MUST BE A9.9-4,0 64.57 XVJ-4'�Q& owir- 4� FIRE REVIEWED By DATE P CITY,�� ZIP TELEPHONE Onr -/V, VARIANCE OR CU SHORELINE OR ADS# INSPEOCPON RE G 0 YES 0 No SON POSTED STp;ICE;E;�BER ....... DATE �IRATION GAT�A C Y SEPA REVIEW COMPLETE EXEMPT SIGN AREA PROPOSED HEIGHT ALLOWED PROPOSED d '74 &) M—OPERTY TAX ACCOUNT PARCEL NO. EXP i -ALLOWED I LOT COVERAGE AEOUIRED SETBACKS (FT.) PROPOSED SETBACKS (Ft.) 0 NEW 0 PLUMBING I MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR 0 ADDITION o C MPLIANCEOR CHANGE OF USE I I PA ARIA KING LOT AREA PLANNING REVIEWED BY DATE PI.ANNINGREVIIINEDBY 0 REMODEL 0 SIGN PEO 0 1 PROVIDED A& ENCE 0 REPAIR 0 GRADING 0 X FT) CYDS MARKS 0 DEMOLISH TANK 0 OTHER 0 CARAGA 0 RETAIN GARPORT AGC,,rWAU. 0 RENEWAL CHICKEDBI fREMARKS ITYPEOF I TAU TION coo OCCUPANT ,?�j GROUP g�; N OF NUMBER UMBER WELL NO ',"�'�TA'.CSAL SPECIAL INSPECTOA E I AREA OCCUPANT LOAD F��n OF NITS NU. E. REQUIRED 0 YES DESCRIBE WORK TO BE DONE —r.AFqq INFIPFCTIONS PER UBC 1081FINAL INSPECTION REG' VALUATION FEE PLAN CHECK FEE E...URCE GLAZING I LOT SLOPE % 0 ILDING PLA ]VESTED DATE PLUMBING MECHANICAL ERMIT COVERS WORK TO THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THISUP t: BE DONE ON PRIVATE PROPERTY ONLY. MY CONSTR CTION ON THE PUBLIC GRADINGIFILL 3 DOMAIN JCURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. S SURCHARGE d PERMIT APPUCATION: i8a DAYS PERMIT 11.111 YEAR ' PROVIDED WORK IS STARTED WITHIN 160 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION ENG. INSPECTION FEE ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS A S ES AS ;APPLICANT OLD HARMLE T E ITY F N INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLE NO LANDSCAPING A E MONDI,WASIINGTON' ITS OFFICIALS. EMPLOYEES, AND AGENT 11 AN ALL CLAIMS FOR DAMAGESOF WHATEVER NATURE, ARISING SIRE T IR TLY INSPECTION FEE RECEIPT FIT M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE 0 PLAN C ..CK.El.SIT FY.WAIVEORREDU Y NC DEEMED TOMODI CEANYREQUIREMENTOFANYCIT OPOINA E PROVISION.' RECEIPT/ NOR LIMIT IN ANY WAYTHE Ct"'S ABILITY TO ENFORCE ANYORDINANCE TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT 01 TI THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL D p I, TION.ANDINO ING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED 0 CODE OF THE STATE OF WASHINGTON RELATING TO -,.P- ack ml FOR INSPECTION IN vtOLATI OwOF THE LABOR WORKMEN'S COMPENSATION INSURANCE AND ROW J8.27. (425) — OFFIC 1.5 SIGNATURE DATE SIGNATURE (OWNE.Ff�/ TTE SIG i V 4NED -ol 771-0220 RELEA SEO 15ATE' i v EXT 1333 ------- ATTENT IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTUREUNTIL 771-0221 —LE INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI ORIGINAL - FI YELLOW -INSPECTOR t". A FINAL HAS BEEN GRANTED. USC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR CATE OF OCCUPANCY z m c) H O"n nj MITI §vi H 0 z 9 0 m