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20010811.pdfDAT """"Ldh ]Lh PERMIT EXPIRES I I CITY OF EDMONDS 'S' PE T NURMMBER')0L_ ()b I I jos SUIT�APTN ADDRESS 0" � / CONSTRUCTION PERMIT APPLICATION OWN��MEME OF BU INESS LLjA, L PLAT NAME,SUBDIVISION NO. L T�O I LID NO. LID FEE S MAILINGADDRESS i6-3,ol PUBLIC RIGHT OF WAY PER 01110Al STREET MAP S I U".P. 4 R d ED3 EXISTING — PROPOSED o o CITY fa-be"wr"s q rjq E.UIRED DEDICATION— FT "NAME METER SIZE LINE P V REQUIRED YEE . N. -ADDRESS A MARKS OWNERICONTRACTOA RESPONSIBLE FOR EROSION CONTRO�DRAIWAGE CITY zip TELEPHONE NAME 7,-4 ENGINEER'.. REVIEWEDIDATE ADDRESS FIRE REVIEWEDBY DATE CITY zip 0 TELEPHONE VAFIIAICE .� CU SHORELINE OR I.El. INSPECTION RED D [3 YES n NO PBO D OSTEC STATE LICENSE NUMBER EXPIRATION D SERA REVIEW COMPLETE I EXEMPT SIGN AREA ALLOWED I PROPOSED HEIGHT AllOW10 PROPOSED PROPERIV TAX ACCOUNT PAR CEL NO. A4�1 6 5?,& q A41 0 NEW PLU.1 ER GE ALLGWTElCoV PROPOSED REOUIRED SETBACKS jFT. FRONT SIDE REAR PROPGS D SETBACKS FRONTEURSIDE REAR C..PL�NGIMECH 0 AL)DITIDN ANCEOR CHANGE OF USE REMODEL SIGN PARKING EQD LOTAREA I PRDVIOED PLANNING REVIEWED BY DATE GRADING CYDS Cl �ENCE x m REPAIR 0 DEMOLISH C] TANK 0 OTHER IARAGE M RETAINING WALL RENEWAL CARPORT ROCK�RY IR.A P (TYPE OF USE. BUSI TIVITY) EXPILAIN: I'll, I tj CHECIIDBY ITI STRUCTION CUPANT lo 177 GROUP M _NU�R OF STORIES NU"ItROF DWELLING UNITS CZ"ACA' �U.. S E R BPE.IALINIPECT.R JAF�A "�OUIFIED [3 yes I OCACIU-NT L. DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REG' H -r 9m) - j?44& tmw� &a 92�1`4 VALUATION FEE PLAN CHECK FEE 395�' mEAT SDURCE OIAIINI = LOT SLOPE &A_4� I eu]LDING 0, PLAN CHEC IVE5TEDIIAIE PLUMBING MECHANICAL THIS PERMIT AUTHORI��S ONLY THE WORK NOTEO. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GBADING/FILL DOMAIN (CUREIS. SIDEWALKS, DRIVEWAYS, MAFIQU EES. ETC.) WILL REOUIRE SEPARATE PERMISSION — STATE SURCG PERMIT APPLICATI N: ISO DAYS PERMIT LIMIT. I YEAR . PROVIDED WORK IS STARTED WITHIN ISO DAYS ENG. REVIEW FEES I SEE BACK OF PINK PERMIT FOR MORE INFORMATION ON BEHALFOF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCE50RS �T'oN FEE ENG INSPECTION FEE SPE'l ;APPLICANT. u N NTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF SCAP'NG LANDSCAPING I EDMONDS WASHINGTOM ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANYAND ALLC�IMSFOR DAMAGESOF WHATEVER NATURE. ARI SING DIRECTLYOR INDIRECTLY INSPECTION FEE REcElp 2 HIS PERM I SHALL NOT BE FRDM THE ISSUANCE OF THIS PERMIT. ISSUANCE oFT PLAN CHECK DEPOSIT 2 DEEMED 0 MODIFY. WAIVE OR REDUCE ANY REQUIREMENT o F ANY CITY ORDINANCE 5 NOR LIMITT IN ANYWAY THE CITY 5 ABILITY 10 ENFORCE ANY o RDINANCE PROVISION I _ TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE FIAG THIS APPLICATION. THAT THE INFORMATION N APPROVAL GIVEN 15 CORRECT. AND I. AM THE OWNER, OR THE DULY AU HORIZED AGENT 01 AT' T� .7 THEOWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL B., . . . .... . D TION, AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LA NGTON RELATING TO BOA CODE 01 THE STATE OF WASH$ FOR INSPECTION WORKMEN S COMPENSATION INSURANCE ANDRCW IS 27 OF C�A S SIGNATURE DAT�E LS T (425) 771-0220 Fi LEASE Ell -A ATTENTION EXT 1333 ITISUNIL FULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL AW A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 771-0221 I To. ORIGINA E YELLOW INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 FAX PINK - OWNER - GOLD ASSESSOR ,so z 0 4 0 m C3 x c m rn a 0 80 c m 10 c — z O"n m fm rn c- 0 0 c c 0 z m 311, L 'T E�O-1 AMCA! OAit--,+-1 .3,3 SS. -vf.6co S�. 119E EIVED OCT iZ 2 2001 ING DEFT. Al T3!PATI-y io s ,.I Tis /fl? 0/ '4A W- 14- RECORD OF INSPECTIONS INSPECTOR DATE APPROVED -SETBACKS ................... FOUNDATION: Footing...................... wall.......................... Pier/Porch ................. Z: Wall Retaining ........... M Slab Insulation .......... PLUMBING: Underground ............. 0M Rough -in ................... 0. Commercial Final HFATING: Gas Test .......... it Gas Piping 5 05 ................. Equipment ................. Commercial Final ITI 0 EXTE IOR SHEATHING R NAILING.......................... FRAMING ..................... 0 FIRST FLOOR FRAMING L)k INSULATION ................. Floor Insulation Wall Insulation ........... Calling Insulation SHEETROCK NAILING SPECIAL INSPECTION ITI MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. t FERMIT P EXPIRES PERM T CITY OF EDMONDS WMNR,� LI CONSTRUCTION PERMIT APPLICATION SUITUAPTS 'AODBRESS j .FJNA.E OF BUSINESS _4_TJ , ILLIPN% L 7 PLAT NAMEISUBDIVISION N a LID NO. LID tEE S MAILING ADDRESS p E3 0301 AtibovE(t �T. Ay PER OFFICIAL STREET MAP PUBLIC RIGHT OF ;T ;E,',.' 0 0 CITY ZIP HONE EXIS ING - PROPOSED Q 0 ITILE I q&Z G 4;L:5- (7q&-&lcL F.OIJIRED DEDICATION- IT 0 METER SIZ� PRV REOUIRED NAME YES E3 NO C3 ADDRESS -REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE CITY ZIP ITELEPHONE NAME ..INEERN. REVIEWEDIDATE N ADDRESS Rl FIRE REVIEWED BY DATE CITY, ZIP TELEPHONE VARIANCE OR CU SHORELINE OR AD. I INSPECTION -STATE LICENSE NUMBER EXPIRATION ATE Y RE 0 0 ES [3 NO PBOND OSTED SEPA REVIEW COMPLETE EXEMPT FD SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED PROPER- 7:;ZF (go EXP I _LLLLL , O.NEW RESIDENTIAL I ING I MECH M LUMSING f MECH LOT COVERAGE LOT COV E LOWE POSE. ALLOWED PROPOSED REQUIRED SETBACKS IFT.) FRONT SIDE REAR PROPOSED SETBACKS (Fl) FRONT UPSIDE FEAR ADDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE DATE REMODEL APARTMENT SIGN Ea PARKING R D PROVIDED LOT AREA PLANNING REVIEWED BY FENCE C] REPAIR 0 GRADING CYDs X - IT) MARKS C] DEMOLISH C] TANK OTHER 0 GARAGE RETAINING WALL FINE./ 0 CARPORT RCKKEFY BUS ACTIVITY) EXPLAIN: 0 PANT CCUPA 0 CUP F (TYPE OF USE. _r,�R CHECKEDBY ITYT/VSTRUCTION 1j;P7 CICROUP e _�U�MBER NUMBIER OF CRITICA AREAS SPECIAL INSPECTOR 0111-"T IT OF OWELLIN NUMBER JAPEA LOAD REQUIRED [] YES UNITS DESCRIBE WORK TO BE DONE R.lrNUAI INS:PECTION RED' CTcn FUA FEE PLAN CHECK FEE V/ GI.AlING % HEAT SOURCE LOT SLOPE % BUILDING &A-S I cw IIESTED DATE PLAN CHEC PLUMBING MECHANICAL THIS PERM NOTED. THIQ PERMIT COXS WORK TO ONLY THII WORK ONLY. ANYCONSTRUCYIONCN PUND' BE DON ON PRIVATE PROPERTY DOMA13AUTHORIZES (CURBS. SIDEWALKS, ORIVE WAYS MARQUEES, ETC) WILL REQUIR0 PEA�j SEPARATE SSION . P E MITAPPLICATION: 180DAYS . RKISSTARIIDWITHIN ISODAYS 'MIT:' Y A 0 PERMIT L E ENG. RE JEW FEES ;;ROVIDlDW SEE BACK . INK PERMIT FOR MORE INFORMATION -A PLICANT. ON BEHALF OF His OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS P ENG, INSPECTION FEE IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING I EDMONDS. WASHINGTON. TTSOFFICIALS� EMPLOYEES. AND AGEM.TS FROM ANYAND ALL CLAIMSFORDAMAGESOFWH ATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY INSPECTION FEE RECEIPT FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT DEEM5070 MODIFY. WAIVE OR REDUCE ANY REQUIREMENTOF ANY CITYORDINANC 0 NOR LIMIT IN ANY WAYTHE CITY SABLITYTO ENFORCE ANYORDINANCE PROVISION. TOTAL AMOUNT DUE RECEIP I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION' THATTHEINF AMATION APPLIC ION PPROVAL GIVEN I CORRECT. AND THAT I AM THE OWNER, OR THE D ULY AUTHORIZED AGENT OF S T -t IT 0-11 " "ll"d III - THEOWNER. I AGREE TO COMPLY WITH CITY AND S FSOUI-ATIN.GE CONSTRUC STATE LAW D CALL dllg - Dly-d 1.,, 11, pald-,I TION AND IN DO NO THE WORK AUTHORIZED THERE NO PER ON WL EMPLOYE I By 7 RELATING 0 ..l,,d90d In Waw PIP-d FOR INSPECTION IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON DATE WORKMEN S COMPENSATION INSURANCE AND ACW 18-27. 'A T (425) OF#C,,ALS SGNATURn 'ENT) /1�7/E;/ 771-0220 E EXT 1333 ATTENTION V IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-02il A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI OW INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK OWNER GOLD -ASSESSOR "a z 0 c In In 0 7, 0 80 r_ m m ca 0 "n (3 0 0 0 X z 9 m