Loading...
20010816.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMENAME OF B SINESS 5;e_,,,tt t L,�,A, MAILINGADDRESS CITY ZIP I TELEPHONE 2 / I I PERMIT EXPIR S USE PERMIT ZONE /6(o NUMBER JOB SUITE/APT# ADDRESS P/Z�dlc_ PLAT NAMEISUB01VISION NO. I LOT NO, LID No LID FEE 5 1-0-- u PUBLIC RIGHT .1 WAY PER OFFICIAL STREET MAI 0 0 EXISTING — PROPOSED CI REOUIREDOEDICATION— IT PRV REOUIRED 13 0 & YES NO R MARKS OWNERCONTRACTOR RESPONSIBLE FOR EROSION CONTROL/ORAINAGE ... 8 ADDRESS CITY ZIP ITILIPHONE NAME ENGINEERING REVIEWEDIDATE m ADDRESS 0 FIRE REVIEWED BY DATE CITY ZIP 0 TELEl"OlE4,_ VARIANCE OR CU SHORELINE OR ADB4 INSPECTION REGO 0 YES ONO IPBON OST 0 STATE LICENSE NUMBER SERA REVIEW COMPLETE I EXEMPT SIGN AREA ALLOWED , PROPOSED HEIGHT ALLOWED PROPOSED PROPERTY TAX -40 aExp 0 NEW ]g RESIDENTIAL 10:1 LUMBING I MECM C] ADDITION C] COMMERCIAL C3 C MPLANCE OR CHANGE OF USE 0 APARTMENT SIGN C3 REMODEL 0 FENCE REPAIR GRADING CVDS X F,l OTHER DEMOLISH Er TANK ARA E NINO WALL Z 0 GCA.PG..T C] RETAI 0 RENEWAL ROCK, Y LOT COVERAGE ALLOWED PROPOSED REOUIREDSErBACKS(FT.) FRONT SIDE REAR PROPOSEOSETeACKS(".) FRONT � pR SIDE REAR PARKING J_ RE ..D .VICE. LOTAREAjidbIM*jWAL DATE BE PRESEN T 17013 E.AF- I MiJA rILL, �iEMOVAL, OR rAP 9 JTYPE OF USE BUSINESS OR ACTIVITY) EXPLAIN: QXVMFn LkWFOOn I IS W77N O�CUIA C G Up'�kS NUMBER kj 0 OF a STORIES NUMBER ORJ DWELL N. UNITS I ICA LP EAS 'UMBER SPECIAL INSPECTOR REOUIRE C3 YES ocou R—EA PANT LOAD DESCRIBE WORK TO BE DONE I, 'a-voiz, Ix REMARKS R UBC I GOJIFINAL INSPECTION REO'D PROGRESS INSPECTIONS PE u +uvL4L 149,qf� din If VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING I LOT SLOPE BUILDING IPLUMBING! PLAN CHEC I—STED DATE =_ MECHANICAL �TO IRS WORK THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON,THE PuBUC DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS . MARQUEES, ETQ) W LL REOUIRE SEPARATE PERMISSION. GRADING(FILL PERMITAPPLICATI N: 180DAYS PERMIT LIMIT.- I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION END REVIEW FEES ENG INSPECTION FEE L11A N ' ALIOF IS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS -A" '. 'TiCk RE"E INK IN IN ES ". DEFEND AND HOLD HARMLESS THE CITY 01 . S TO DEMNI III EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES�AND AGENTS FROM ANY AND ALL CLAIMS FOR DAM DES F WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY FROM THE I= IC OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE E EE.EOT ,WAIVE OR REDUCE ANY E.LIREMENTOFANYCITIORDIIANCI o NORLIMIT IN ANY WAYTHE CITY S ABILITY TO ENFORCE ANY ORDINANCE IRO:::j� LANITSCAPING INIPECT'ON'll POI T P PLAN CHECK DEPOSIT o R ECEIFT TOTAL AMOUNT DUE I RECEIPT IERERY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION F APPI GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE A THORIZEDAGENTO LAW REGUI-ATINGCONSTAUG THEOWNER I AGREE TO COMPLY WITH CITY AND STATE S CALL T G T EDTHERE Y. 0 PERSON WILL BE EMPLOYED ANDIN OING HEWORKAUTHORIZT B RELATING TO INSPECTION S ,ION ON IFOR N VIOLATION OF THE LABOR CODE OF HE STATE F WASHINGTON WORKMEN SCOMPENSAT2=NCE ANDRCW 18.27� s I IURE DATE S� SIGNATURE, ­oF GfNl) DATE SIGNED (425) r�S ;;� 771-0220 A-tYENTION EXT 1333 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 YELLOW INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED, USC SECTION 109 FAX PINK OWNER GOLD ASSESSOR z 0 m c 0 IT! 0 80 c m 10 2 ?t 0 m M 0 0 0 z z 9 0 m / Lt 00 FINAL PROJECT APPROVAL FORM TO:- DATE: — MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE ENGINEERING DIVISION DATE — PLANNING DIVISION DATE — PROJECT SITEADDRESS ERMIT #2�g �- P ADB#______PATE INSPECT DESCRIPTION OF WORK TO BE INSPECTED A field inspection was conducted to determine final compliance with approved plans. Final approval ere are no objections from the above signed Department to the release of denotes that th _PERFORMANCE BONDS and the granting of: GRANT FINAL PROJECT APPROVAL q GRANT PROJECT APPROVAL WITH CONDITIONS NOTED u Copy of CONDITIONS given to owner/contractor by inspector 1. FAILED FINAL INSPECTION - OUTSTANDING ISSUES C3 Copy of CORRECTION NOTICE given to owner/contractor by inspector 1. 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL ocaprvl.doc.l:te�ip:bldg:formslO/01 z 0 i 0 0 C M MO --1 0 0 0 C X M M z --i z o -n n M M U 0 0 M C cf) 9 Cn M 0 z � z z 0 q 0 M RECORD OF INSPECTIONS m m m 10 co 0.1 A W R W 27 E RECr OI14_1 -'E:�� PERMIT EXPIRES CITY OF EDMONDS USE P RMT ZONE ks ('2 NUMBER ��XI-081(D CONS TRUCTION PERMIT APPLICATION JOB UITEJAPTV ADDRESS V/av_ . OW;�ZM�Ak�l BUSINESS �dg, P�T NAME]SUBDIVISION NO. I LOT 110. 11 NO, MAILINGADDRESS 5 30 aa, PUBLIC FIGHT OF WAY PER 0 FFICIAL STnE ET MAI LID FEE S 0 M A�u. =P-1 Rd� d 8 CITY zip EXISTING — PROPOSED— I— — ITELIPHONE 44 �5— _77q —1-2 REQUIRED DEDICATION— FT — NAME METER SIZE I LINE Sig__[_;0.OF FIXTURES Y'PRV REQUIRED s C3 No C3 9 ADDRESS REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAWAGE CITY ZIP ITELIIHONE NAME F'aU 7- 'GINEERING FIEVEYWATE IDDREll A- uer5 z D ATE ZIP TELEPHONE FIRE REVIEWED BY C, 0 STATE LICENSE NUMBER ­FIHAIIUNDATE VARIANCE OR CU SHORELINE OR ADEM INSPEC�ION REO D IPBOND OSTED SIGN E3 YEE HEIGHT SERA REVIEW COMPLETE EXEMPT AREA ALLOWED PROPOSED ALLOWED PROPOSED PROPERTY TAX d�O;g�; I I , In I EX, LOT COVERAGE REQUIRED SETBACKS (FT.1 PROPOSED SETSACX� tFT.) m 0 NEW RESIDENTIAL C3 PLUM81NG f MECH ALLOWED PROPOSED FRONT SIDE REAR FRO�T UR SIDE REAR 0 0 ADDITION C OMMERCIAL C PLIANCEOR CHANGE OF USE - APARTMENT C:] SIGN PARKING I LOT RECIT) PROVIDED AREA ri-ANNING REVIEWED BY DATE m C] REMODEL 0 FIR MARSHAL 10 FENCE REPAIR GRADING 0 _ , r CYDS FT) RE.AIIX. MUST BE PRESENT FOR DEMOLISH TANK ci OTHER YANK FILL, REMOVAL, OR CAP 0 GARAGE RITAIN:NGWALL RENEWAL CARPORT R.X . 0 0 n � - (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLA,IN: D % CHECKEDBY Ily CTION CURA GR CUP lc�7 10 Z3 mm NUMBER OF NUNBE.0 D E LUNG CRITICAL AR EA. SPECIAL INSPECTOR R EQUIREO JAPEA OCCUPANT LOAD a rn STORIES UNITS NUMBE I, C] YES C ri) DESCRIBE WORKTOSEDONE 0, REMARKS If% -�;00 PROGRESS INSPECTIONS�PERI UBC10aIFINAL INSPIE6TIONREO'D u ra 0, KP�NCHECKFEE VALUATION FEE z 9 GLAZING I LOT SLOPE % BUILDING 0 m PLAN CHEC IVESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO PUBLIC 31 DREDONEON PRIVATE PR OPERTY ONLY. ANY CONSTAUCnON ON THE OMAIN (CURBS, SIDEWALKS. DRIVE S. MARQUEES. ETC.) WILL REQUIRE WAY GRADINGIFILL 9 SEPARATE PERMISSION. �U.C.ARGE 0,�j PE MITAPPLMJ�)ON; 180'PM*� ISODAYS PERMIT LIMIT. I Y EAR -PROVIDED *ORK IS STARTED WITHIN SEe BACK OF PINK PERMIT FOR MORE INFORMATION ENG.REVIEW FEES -APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS ENO. INSPECTION FEE IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAP No M EOMONDS.WASHiNGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANYAND C WHATEVER NATURE� ARISING DIRECTLYOR INDIRECTLY NSPECTION FEE w ALLCI-AIMSFOR DAMAGESOF X FROM THE ISSUANCE OF THIS PERMIT. ISSUAN E .1 -IS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT IRECEtPT - ==- WAIVE 0. REDUCE ANY E.UIREMENTOF ANY CITY ORDINANCE TO ENFORCE A Y ORDINANCE PROVISION. CEIPT N WAYTHE CITY*S ABILITY TOTAL AMOUNT DUE [FOR A 1. IHEREBY ACKNOWLEDGE THAT I HAVE REA. THIS APPLICATION THAT THE INFORMATION APPLICATION APPROVAL GIVEN I CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF S I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING C ONSTRUC- Th,, ppj­j.­, p1lil ­111 1�9.ld by thl CALL THE OWNER TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Off —I .1 h-1 O.Pull: Pd F ... ... ... d­� ,­p­ —ladged., 1p— P—dad. IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO INSPECTION WORKMEN S NCEAND C 18, SSIMATURE J� E —SIGNATURE COMPENSAT= DATE SIGNED (4�5) �07NER OR�Gfll`) I 771-02 FELWEDIW 20 I DATf A7ft'64TION EXT 1333 ITISUNLAWFULTOUSEOR OCCUPY A BUILDING OR STRUCTUREUNTIL 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW � INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR