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20010789.pdf-�77- 11 RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEfN ESS jagSIN -0-N50 MAILINGADDRESS 11 Tzq06 LWAA05 WAY 017 CITY IF ID )'V05 qyo?-o ITEL11111E CITY ZIP jTELEPHOI,Il NAME yt7 JIV( A0057X _3 ADDRESS I Z8 jq g 31 '/37- CITY III, 1 TELEI"ll (?Furvuff 0 qZr- 373 -1700 0 NEW 0 RESIDENTIAL LUMBING / MECH 0 ADDITION COMMERCIAL 0 OMPLIANCE OR CHANGE OF USE 0 REMODEL V Ap��o 0 SIGN Ig REPAIR 0 GRADING Cy. 0 F NCI I — x FT' 0 DEMOLISH 0 TANK OTHER 0 GARAGE 0 RETAiN.ING WALL — a=KB 0 RENEWAL n S — NUMBER OF NUMBEROF DWELLING UNITS UHEA" AR S NUMBER _STORIES DESCRIBE WORK To BE DONE 17U 7—] PERMIT EXPIRESl USE PERMIT ZONE NUMBEROUl JOB "ffAlTl ADDRESS W i:�—1 PLAT NAMEJSUBDIVISION NO. LOT No LID NO� — LID FEE S PUBLIC RIGHT OF WAY PEI OFFICIAL STREET MAP .P. EXIS tNG— PROPOSED — REQUIRED DEDICATION� FT — d METER SIZE I LINE SIZE 1 10, OF MIXTURES P REQUIRED YEE E3 No C3 ARKS N 1—TRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE T FIRE REVIEWED BY DATE VARIANCE OR CU SHORELIN E OR ADB. INSPECTION I PEOND AEO'D OSTED 0 YES ONO SERA REVIEW SIGN AREA I HEIGHT COMPLETE I EXEMPT ALLOWED I PROPOSED ALLOWED PROPOSED -�F I LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT YRSIDE REAR PARKING LOT AREA I PLANNING REVli�ED BY DATE REOG I PROVIDED I fLLYPE OF CONSTRUCTION C OCCLIPAN 2!!NOPOUP p— CUPANT [SPECC�'AlOINSIECTOR OL.�A D RE.0 RED [3 Y S JAREA =RKS IE —caQ lMQO9rTInNIr PER U13C 10PIFINAL INSPECTION REO'D q P L A K E C' HEAT SOURCE GLAZING % T P E I LOT SLOPE L 0 L 0 L D I N BUILDING B U M N G PLUMBING L U PLAN CHECK NO: DATE V S T E D D A I A L MECHANICAL E C A N C _rSTED E R M I T C 0 V E R S W 0 R K 7 0 THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THISUPERMIT COVERS WORK TO C N ON THEPUBLIC DONE ON PRIVATE PROPERTY ONLY. ANY CONSTR 'U C I 0 N 0 CTIOC.) R N L GRADINGIFILL G A G IN I ED U E DE WILL REQUIRE E T C I L OMAIN (CURDS. SIDEWALKS, DRIVEWAYS. MARQUEES, ET SEPARATE PERMISSION. A R G STATE SURCHARGE ST AT E U R C PERMIT APPLICATION: 180 DAYS IN IT I N Ay B I YEAR - PROVID D WORK IS STARTED WITHIN 180 DAYS PERMIT LIMIT. E EN V W F E ES ENG. REVIEW FEES RE 'E A T - 0 N SEE BACK OF PINK PERMIT FOR MORE INFORMATION N T '0 N FEE ENG INSPECTION FEE END E. AS E G A N SU CIE OR I S -APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS H A R LE BE T H E CITY . F IN INTEREST. AGREES TO :NDEMNIFY. DEFEND AND HOLD HARMLESS.THE CITY OF ANY A, ANY AND I - LANDSCAPING LA NO G A' E N ,ND AD E NT S FRO 2 EDMONDS. WASHINGTON. TS OFFICIALS. EMPLOYEES. AND AGENTS F OM Y INSPECT I N F EE I CTLY 0 R 'N.'.E.' G RE ALLCILAIMS FOR DAMAGESOF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY B ,HIS PERMIT SMALL NOT BE FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SMALL NOT E PLAN CHECK DEPOSIT PLAN C HECK EF.E'T E DEEMEDT MODIFY. WAIVE OR REDU E ANY REQUIREMENT OF ANYCITY ORDINANCE ' T 10 WAYTHECITY S ABILITY TO ENFORCE ANY ORDINAN CEP— N. NORLIMI MANY TOTAL ... UNT.UE TOT L M. T G I HEREBY ACKNOWLEDGE THAT I HAVE READ T.ISAPPLICAT ION: THAT THE INFORMATION , L IS U Y .. OFIZE. G T GIVEN CORRECT. A 0 THAT I AM THE OWNER. OR THE DUI-Y AUTHORIZED AGENT 01 WE RE.U' ING Co"'STRUC THE OWN AGREE To COMPLY WITH CITY AND STATE LAWES REGULATING CONSTRUC ER I L L CALL P Y D TION. AND IN DOING THE WORK AUTHORIZED THEREBY. No PERSON WILL BE EMPLOYED RELATING TO RE L T, . TO 0 P T FOR INSPECTH N S I GT IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON WORKMEN S COMPENSATION INSURANCE AND RCW 1827 TE SIGNED G A T E. G (425) 71-0220 7 _0 0 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 :f_U�ATIONIEE ,5-6 T" 1.9— b, 'u.'., F .1. �, —1.pt �l 1--lodgld 1. P ... —dod YELLOW � INSPECTOR PINK -OWNER GOLD . ASSESSOR z 9 - 0 IT, 'o 00 r- '-0 a 0 -n n m M a 0 o Fn C (a 0 z 9 0 rn RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... wall.......................... PieriPorch ................. Retaining Wall ........... Slab Insulation .......... PLUMBIN13: Underground ............. Rough -in ................... Commercial Final HEATING: N Gas Test .................... Gas Piping ................. Equipment ................. Commercial Final EXTERIOR SHEATHING NAILING .......................... FRAMING .................. —7 FIRST FLOOR FRAMING INSULATION ................ Floor Insulation Wall Insulation ........... Calling Insulation SHEETROCK NAILING SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FO R OCCUPANCY .................. if E z 7y, 9171- M 0 M 0 M z —04 5 ! M c 77 10 CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEM" BUSINESS 5'),q r, -rtN Tzq06 tOOON05 I ZITY ZIP wmavol IY02-0 dul USE PERMIT ZONE NUMEIEP�Uj -10 joADDRESS PUT NAMEAUBDIVISION NO� T LID NO. LID FEE 5 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Xp�.� I, 8 EXISTING — PROPOSED sClm=pl"_l.lwl 0 0 REQUIRED DEDICATION— FT — J..,C—C ." I— — METER SIZE LINE SIZE NO. OF FIXTURES PAV REQUIRED YES 0 NO E3 N REMARKS 111—ITRACTOR RESPONSIBLE FOR EROSION CONTSOLDRAINIGE 01W -xAvu5Ta5 M/(- ENGINFEING- ,HEVIEWEDOATE Ess "41 Ea 12B jq .5,e 31 Y37 FIRE REVIEWEN9 DATE ZIP J�W7NIJ)t�. r 171 thm- 9.0. 00 L'% /700 -.)Crw.K G STATE LICENSE NUMBER 01"ATU RfmOn LL VARIANCE OR CU SHORELINE OR ADDS I INSPECTI N REDID [3 'YES 0 NO 0 SON P OSTED SEPASEVIEW SIGN AREA PROP01111 HEIGHT ALLOWED PROPOSED PROPERTay milU-4 GO PLETI I EXEMPT 'Xp ALLOWED I , C VERAGE LOTCOVERAGE REQUIRED SETBACKS (FT.) REQUIRED B.-ACKS I-) PROPOSED SETBACKS (Fr.) PFIC 0 NEW 0 PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT LIFISIDE REAR 0 ADDITION 0 COMPLIANCE OR CHANGE OF USE PA ING LOT AREA PLANNING REVIEWED BY DATE 0 REMODEL 0 SIGN RED 0 PROVIDED 77T!n: I -,. FENCE 0 GRADING CYOS 0 x I IMAKS_ - 0 DEMOLISH 0 TANK tR( oGARAGET — CARPOR M RETAINZ2 WALL 0 RENEWAL Is (TYPE OF USE. BUSINI(S)OR IN: I (A C CONSTRUCTION CCUPANT U FOUP ?'�LOCo..UPANT I NUMIER "'AL OF DWELLING 010 REA LOA STORIES L� UNITS NUMBER jo REQUIRED YES DESCRIBE WORK TO BE DONE R P EBB INSPECTIONS PER UBC _108/FINAL INSPECTION REC� W�4�er J(AWA 60 A -5h00"InA VALUATION I FEE PUN CHECK FEE I HEATSOURCE GUDNG % LOT SLOPE % BUILDING 15� 6_�57 -PLAN CHECK NO: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON TH E PUB UC GRADINGIFILL DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS . MARQUEES, VC.) WILL REQUIRE SEPARATE PERMISSION. STATE SURCHARGII PERMIT APPLICATION: I-()GAYl A. PERMIT LIMIT.- I Y ' PROVIDED WOR IS STARTED WITHIN IM) DAYS FAR K ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION _ ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS N.m ENG. INSPECTION FEE ;APPLICANT. N NTEAEST. AGREE S TOINDEMNI DEFEND AND HOLD HARMLESS THE CITY OF Ih D ANY AN LANDSCAPING a EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ALLCLAIMS FOR DAMAGESOF WHATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY INSPECTION FEE RECEIPT oT E 1 no" THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL N BE PUN CHECK DEPOSIT Z 9 DEEMED To MODIFY. WAIVE OR REDUCE ANY RE.UIREMENTOFANY CITY ORDINANC PROVISION,` 1 NOR LIMIT IN ANYWAY THE CITY4S ABILITY TO ENFORCE ANY ORDINANCE . TOTAL AMOUNT DUE RECE I HEREBY ACKNOWLEDGE THATI HAVE READ THIS APPLICATION; THAT THE INF RMATION APPLICATION APPROVAL GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DuLY AUTHORIZED'AGENTOF 'DhiN0-'D �Ya`l THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- E CALL ,dTl`9.0-FCICI PC'Iy:%'ul-d"F-e'0Ql"C TION, AND IN DO NO THE WORK AUTHORIZED THEREBY. NO PERSON WILLBE LEMI ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RE AT'LOY I N VI I I No TO FOR INSPECTION ,,,.pt,s ack.C.Ildged 11 IP— PIC WoROUT KM5NS COMPENSATION INSURANCE AND RCW 1827. T' FFI NATU OTE I SIGNED (425) rN_=8aL__7GATE lo-1 k.YELLOW 771-0220 IL D BY f DATE 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- ORIGINAL - FILE INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER - GOLD - ASSESSOR z 0 m sm M 0 0 0 c m z E - >Z c� I :� 0 n m m a 0 0 Fn cm mw cl z 0 q 0 m