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20010731.pdfRECEIVED (/ I USE ZONE PERMIT CITY OF EDMONDS NUMBE&V-P CONSTRUCTION PERMIT APPLICATION JOB ADDRESS SUIT IPTI --M—AME OF BUSINESS _jr el K0 PLAT NAMEiSUBEAVISION NO. LOT NO. L�DIY AILING ADDRESS D FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TES PAN,—d W P R.qu..d 7f at —I U1. 1.1- R _F 7Ty— ZIP I TPLEPHONE EXIST flq",rfP8fE . - . oleo_ _Vj jfi�!!�TF Tew" , " RE wwp e er OU�'F't E e wate'. _O 1(9 2X, L I METER - AINE F, .�; X111.1 wy8x, ......... .. ZIP TELEPHONE NAME DRESS Aw*,v,+-vmt mizeetors REVIEW required on fuel -burning appliances 1-2,Uol kingi.1 A -JP, II'l C_ i-CITY IP ITELEPHONE 0 - osq CA22)91 -311-4 xl TATE LICENSE NUMBER EXPIRATION DATE OR CII SERA REVIEJ, COMPLETE EX EXP 11 A PROPERTY TAX ACCOUNT PARCEL NO. NEW ESIOENTIAL PI ..EIN. I NEC- PLIA.CE OF dA..ITION 0 COMPLIA CEOR CHANGE OF USE U REMODEL [!Z 1-1 SIGN E 0 REPAIR GRADING FENCE CIDS X Fr) X FT) 0 DEMOLISH TANK 0 OTHER A 0 F _W 0 R"AINING 'NALL RENEWAL =�ET _X _R, 0 AL LOT C ALLOWED 0 j PARKING PARKING REaD FIS. D I PROVIDED PROVIDED A MARKS MA KS (TYPE OF USE. BUSINESS OR A N: TYPE NUMBER OF STORIES NUMBER 0 F DWELL N UNITS .GEOF AL AREAS NU MISER f.E P C B LAL AE,� R E I CT. S.U, 0 . REQUIRED 0 YES DESCRIBE WORK TO BE DONE REMARKS sm. kAM 117-00nn mvumEub iNSP r ROGR SS SP 0 IN. 0 1 NAGE1 is I @ E3Y5S ONO I SIGNAREA HEIGHT 91 PIUPP@EW _TLLOWEO PROPO E ��;M SHM. )FF PC R9994AMI("P A08SED SETBACKS (FT.) UPSIDE REAR PI-ANN 0.0261E MWWN.3 2 REGULAM9VALVE(PRV) BE INsTALLM NEAR Ir - ICT17CUPANT a P 1�3 PANT LOAD OCOU IER UBC 1081FINAL INSPECTION REO'D z VALUATION FEE + PLAN CHECK FEE HWAQVRCE GLAZING 1, LOT SLOPE BIJIL.I.. PLAN CHECK NO: jV11TEO DATE U PLUMBING rGRADINGIFILL MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO !Z BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON T E C 2 N RPUBUC 3 DOMAIN ICURBS, SIDEWALKS. DRIVEWAYS MARQUEES. ETC.) WILL EOUIRE G, . �LL SEPARATE PERMISSION. 64?aCHARGE PERMITAPPLICATI N: 180DAYS PERMIT LIMIP. I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE W , IN NTEREST. AGREES 10 INDEMNIFY. DEFEND AND HOLD MRMLE16 THE CITY OF 7NDSCAPING I EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND IA LCLAIMS FOR OAMAGESOFWHATEVER WTURE.ARISINODIREC7LYOR INDIRECTLY INSPECTION FEE FA M THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE RECEIPT 5 DEEMED TOMODIFY. WAIVE OR REDUCEANY REOUIREMENTOF ANY CITY ORDINANCE ILNOR LIMIT IN ANY WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' PLAN CHECK DEPOSIT IRECEIPT/ TOTAL AMOUNT DUE L E TH I HAVE READ THIS APPLICATION. THAT THE INFORMATI N = IYS=WCT.E= THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL T HEOWNER. I AGREE 70 COMPLY WITH CITY AND STATE LAWS REGULATING CON57RUC. T. IN Sol CALL T 1 . Par- ever. NO IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN I ILATI? Dev,ly: a-d Feez are ped—o WOR.. E2&EF T E STATE OF WASHINGTON RELATING TO ENI E AND RCW 18.27. FOR INSPECTION ..k.-I.dO.d.. P ... PI-d- SIGNATURE 10 OFFICIALS SI NATI 14 —1 SIGNED (425) ok/ % Oki 771-0220 ATTENTIOW— EXT 1333 REdASE. Y DATV ITiS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221 CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX ORIGINAL -FILE YELLOW- INSPECTOR PINK - OWNER GOLD ASSESSOR - Z 4 In r_ M m a m 10 0 _n .n M M 0 0 6 Fn C (0) 0) C, V) z 0 0 m ..... .... . "-;RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... r FOUNDATION: Footing ............ Pier/Porch ............... . Retaining Wall ........... 0 ..qla41risplation ........... PLUMBING:: qn R . V M jz Rough -In ................... ....iCommerzial Fl�af 0 a, HEATING: M Gas f ................... Gas Piping ................. Equipment ........... 0 Commercial Final E)CrERIOR SHEATHING NAILING .......................... 0 Fn FRAMING ........................ FIRST FLOOR FRAMING INSULATION ................... Floor Insulation Wall Insulation ........... so Calling Insulation SHEETROCK NAILING 0 SPECIAL INSPECTION 0 M MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. vp CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF BUSINESS MAILING ADDRESS ADDRESS Hu m FPERMIT EXPIRES us PERMIT ZONE NUMBER 7o—s SUITIVAPTO ADDRESS PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHTOFWAYIER OFFICIAL STREET MAP T11P EXISTING — PROPOSED— l�WR� �d 0 REQUIRED DEDICATION— FT METER SIZE V REQUIRED SO NO 0 'EP NAME ENGINEERING RIEVIEWEDIDATE IF ADDRESS 0 FIRE REVIEWED BY DATE CITY VARIANCE OR CU SHORELINE OR ADEN INSPEC PEOTI N 'D IPBOND OSTED STATE LICENSE NUMBER EXII-1--E CHECKED By 0 YES r ' NO SEPA REVIEW COMPLETE I EXEMPT SIGN AREA ALLOWED , PROPOSED_ HEIGHT ALLOWED , PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. EX P T COVERAGE LOED REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) NEW 0 RESIDENTIAL LUMBINGIMECH ALLOW PROPOSED FRONT S IDE REAR FRONT UPSIDE REAR 0 ADDITION COMMERCIAL ci COMPLIANCE OR CHANGE OF USE PARKING I LOT ARE= DATE REMODEL cl APARTMENT 0 SIGN REGO PROVIDED R 0 REPAIR [:] FENCE 0 GRADING CYDS ( _ X FT) A 0 DEMOLISH 0 TANK [] OTHER oGARAGE CARPORT RETAINING WALL C] RENEWAL R0QXFRY r (TYPE OF USE. BUSINESS OR ACTIVITY) EXE-N; CHECKED By 111PE OF CONSTRUCTION ICODE I OCCUPANT GROW N UMBER NU..ER.' ECIALIDNSPECTO AREA OCCUPANT F. T RIES ""LLN. U NITS AREAS NUMBER SEQUIRI 0 YES LOAD DESCRIBE WORK TO BE DONE VALUATION I FEE PLAN CHECK FEE HEAT SOU CE LOT SLOPE BUILDING PLAN CHECK NO: PLUMDING MECHANICAL T AUTHORaES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK 10 E.""T 'E THIS P E ON PgATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC NE B ." I:F BE ETC.) WILL REQUIRE GRAUINGIFI�L 'CURBS D D.Al. SIDEWALKS, DRIVEWAYS� MARQUEES, SEPARATE PERMISSION. . It STATE SURCHARGE PERMIT APPLICATION: 160 DAYS P. PERMIT LIMIT. I YEAR - PROVID 0 WORK IS STARTED WITHIN la ODAYS E SEE BACK OF PINK PERMIT FOR MORE INFORMATION ENG. REVIEW FEES ENG. INSPECTIO1 EE 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF AND LANDSCAPING EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY ALLCLAIMS FOR DAMAGES OFWHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY INSPECTION FEE RECEIPT FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE — 0 N 'S ABILITY TO ENFORCE ANY ORDINA OR LIMIT IN ANY WAY THE CITY TOTAL AMOUNT DUE RECEIPT I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE IN FORMATION APPLICATION APPROVAL GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF T- - - -- �, .. . P-11 .19�.d �y - �h,�er THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC - CALL ozi�j 0, DoOMY: Ild Fo,, ,, p.d. nd TION. AND IN CIO NG THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED I T WASHINGTON RELATING 0 FOR INSPECTION is acknow?00od,, lo.. p—d... IN VIOLATION OF THE LABOR CODE OF THE STATE OF WORKMEN S COMPENSATION INSURANCE AND RCW 18.27� OFFICIALS SIGNATURE DATE SIGNATURE (OWNER OR AGENT) DATI SIGNED (425) 771-0220 RELEASED BY 07TE wMM"M"— EXT 1333 ATTENTION 1 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- ORIGINAL-EILE YELLOW - INSPECTOR r CATE OF OCCUPANCY HAS BEEN , RANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR z 0 m C-) 0 In 0 co 0 M M 70 Fn M