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20010842.pdfDATE RECEIvIO, PERMITEXPIRES C'TCITY OF EDMONDS IISE PERMIT ZONE NUMBER ()�q Z_ CONSTRUCTION PERMIT APPLICATION C I APT# 'AODBORESS -'HER NAN E OF RUSIN m7:r—V _F Vk. F� 11-AT NAMEISUBDIVISION NO, LOT NO, LID NO. UD HE S MAI LING ADDRESf ES PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED— Ci TY ZIP Ck ,JTELEPHONE 2. S 71- 0115 REQUIRED DEDICATION F" — W_ NAME MUER SIZE I LINE SIZE I No .1 FIXTURES P., REQUIRED NO C3 I .-YES0 ADDRESS A ARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROIJORAINAGE CITY ZIP ITEUEPHONE NAME (�Ien-e Z A L I WX -EN—GINECRING RIEVIEWEDIDATE ADDRESS toon 6sr-t4mujoa�- FIRE REVIMED By DATE bITY ZIP 711 1/ ITILE HONE "t, ?.YZOR94 [L-i PURSUANT TO ECDC 1930.020 vARtANcrAFPFSSIJRHRWtR9&MVA1,VMN SHALL BE INSTALLED E3 No IPBOND OSTEO STATE LICENSE NUMBER E—T I K 11PA R1111IN COMPLETE EXEMPT L � Wwgu�a� ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED NO. P777 'EIMIL �7T NEW LUMBIN / MECH �eAEIIIENTI L LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (ET) 7ROPOSE. FRONT SIDE REAR SETBACKS RFT) FRONT UR SIDE HEAR 0 ADDITION 13 COMMERCIAL 0 CHXrIGMCE OR E OF USE DATE REMODEL APARTMENT SIGN RE F NCE EPAIR GRADING DS _X_Fr) REMARKS A WATER SERVICE SHUTIDFT� DEMOLISH TANK OTHER D ON THE Ei GA E RETAINING WALL ___lAaPPORT ROCKERY RENEWAL TANFERS THE Buit'DIN1111- (ME OF USE, BUSINESS OR ACTIVITY) CHE.. BY J 1,�CCUPANT 20UP 77.13E. OF STORIES N MBER OF DWELLING UNITS CnITICAL AREAS NU.EER L.A. PANt DESCRIBE WORK TO BE DONE REMARKS CTION REQ'D PROGRESS INSPECTIONS PER UBC 11081FINAL INSPE (L VALUATION $ Doscri tion FEE Doscriptlon FEE Plan Check NEXT SOURCE GLAZING % LOT SLOPE % Building PLAN CHECK NO: VESTED DATE Plumbing Mechanical THIS PERMIT AMOPL� ONLY THE WO K NOTED. -16 PERMIT COVERS WORK TO t BE DONE ON PMATE PROPERTY ONLY M" C"N"NUMION ON THE PUBLIC a RIVEWAYS REQUIRE DOMAIN (CURBS. SIDEWALKS. D SCP�1rEPERM;SSI0N. PERMIT UNIT 1 PER RIAPPLICATION; 180DAYS YEAR-PROVID WORK IS STAFRIED �HIN 1. DAYS SEE BACKOF PINK PERMIT FOR MORE INFOR MON Grading Recording Fee Engr. Review city Surcharge Engr. Inspection Statesuicha,ge F H1 OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS ON IIHAI 0 S LESS THE CITY OF IN INTEREST. AGREES TO INDEMNIFY. EFEND AND HOLD HAR u EDMONDS. WASHINGTON ' ITS OFFICMLS. EMPLOYEES, AND AGENTS MOM ANY AND All CLAIMS FOR DAMAGES OF WHATEVER NATURE. —SING DIRECTLY OR INIIREIILY M M THE I11UANCE 01 THIS PIRMRI, ISSUANCE OF THIS PERM SHALL NOT E C YC E DEEMED TO MODIFY WANE OR REDUCE MY AEOURREMENT OF AN IT ITY ORDINAN" NOR UNIT IN ANY WAY �E CrTYS ABILITY TO ENFORCE ANY ORDINMCE PRCVISION,� Traffic Mitigation Plan Chk Deposit Fire Review Receipt III Fire Inspection TIGIBIAMOUnt Ue L,n�s,,P, Inspl I HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION; 1. TH INFORMATION APPUCATION APPROVAL GIVEN 0 CORRECT, AND THAT AN THE OWNER. OR THE DULY AUTHORIZED AGENT OF � THE OWNER. I AGREE To WMPLY WITH CITY AND STATE LAWS REGULATING CQNSmTUC- TION, AUTHORIZED THEREBY, NO PERSON WILL BE EM 10YED IN V..j'1N DOING THE WORK RELATING TO 'ON OF THE STATE OF WASHINGTON ' CALL .1d. -d FOR INSPECTION won s co"H�N AND FICW U127. MA u`M' W.R_ S C�� JD�TE BIG to AGENT) '4 L (425) iji-r), 2 771-0220 RfEASED BY DATE TION TION EXT4333- I U LAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I LAWFUL To USE OR 0 A F L INSPEC 771-0221 TION HAS BE�� N MADE AND APPROVAL OR A CERTIFI- YELUOW-INSPECTON SP�CTC . S . CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 FAX PINK.OWNER GOLD -ASSESSOR IDAH /K i "1 049 z 01 3 M C 0 111 0 0 C BRI M z D C 0 M M C3 0 C z C") z 0 1 0 IT FINAL PROJECT APPROVAL FORM TO:— DATE:—,— NEMOTO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE — DIVISION DATE_!��O z ENGINEERING PLANNING DIVISION DATE— Vi -4 0 PROJECT— M M srrE ADDRESS __40 00 C INSPEC ADB# pATEINSPEC PERMIT# ________pATE INSPEC M M Z DESCRIPTION OF WORK TO BE INSPECTED— 10 z A field inspectio, n was conducted to determine final co rup"ance with approved plans. Final approval the signed Department to the release of 0 -n n denotes that there are no objections from above -4 PERF 'E BONDS and the granting of: M M 0 Fn GRANT FINAL PROJECT APPROVAL M (1) Q 0 Z r- GRANT PROJECT APPROVAL WITH CONDITIONS NOTED z u Copy of CONDITIONS given to owner/contractor by inspector z 0 4 0 M FAILED FINAL INSPECTION - OUTSTANDING ISSUES 0 Copy of CORRECTION NOTICE given to owner/contractor by inspector 1. 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date__. Sign___ ocaprv1.doc.1:temp-.b1dg:fbnns 10/0 1 RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... wall.......................... Pier/Porch ................. Retaining Wall Stab Insulation .......... PLUMBING: Underground ............. Rough -in ................... M 'Commercial Final 0 C, HEATI G: N 10 GasTest .................... C _Z Gas Piping ................. Equipment ................. Commercial Final -n EXTERIOR SHEATHING NAILING .......................... M M 5 FRAMING ........................ FIRST FLOOR FRAMING INSULA11ON ................... Floor Insulation Wall Insulation ........... Calling Insulation z SHEETR6CK NAILING SPECIAL INSPECTION M I MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. I -:P-9 D 0= 2. LPERMITEXPIRES ... US ZONE Zo PERMIT Ul N E EDM 0 N DS CITY OF EDMONDS OF NUMBER 0 a RES ADDRESS D CONSTRUCTION PERMIT APPLICATION JOB ON P ERM T A PP ICATION JAO ' Es _ OWNER NAMEftWE OF BUSINESS tr FLAT NAMEISUBOMSION NO, LOT NO, Lin NO, I A (I .. . . "LING ADDRESf — —L PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP R� (AAA T EXISTING — PROPOSED - ff P_ P�� ZIP CITY z� 5 JT11EP"ONE ClYO2 REQUIRED DEDICATION— FT 13 NAME METERSIZE I ET LINE81ZE RES PRV REQUIRED ] YES C3 NO 13 ADDREBI REMARKS MERJC0NTFWCTQR RESPONSIBLE FOR 6 ROSION CO —um — OWN LJORAIMM 1 1 - - I I CITY ZIP TELEPHONE I V-e J,A()(], V\ 0 IT `Pt3 -70(,-7yzo�9 "'o 7 -, I ... .... -4—A 0 HE IALL Z'�.IU:Z11N NECK EWR 0 C.::E CIA M��j CI CE OR 0 CHANGE OF USE 0 REMODEL APARTMENT [I SIGN EPAIR ._.,No C'.. [] FENCE -EMOUSH TANK rl OTHER DAMAGE C ARPORT REMNING WALL OCK _ RY a C RENEWAL -0 (TYPE OF USE, BUSINESS OF ACTWMl E. OF STORIES F-UMBER OF D G U!ELLIN CRITICAL A R REAS NUMBE DESCRIBE WORK TO BE DONE FIRE REVIEWED BY DATE VARIANCE OR CU SHORELINE OR ADS# INS ECTION 4PEO, BOND POSTED E3VES [31,1. S�EPA _R�M COMPLETE EXEMPT SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROP""" EXP I , I LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr) ALLOWED PROPOSED FRONT SIDE REAR FROM UR SIDE REAR I PARKING LOT AREA I PLANNING REVIMED BY DATE REO'D PROVIDED I CHECUDBY JTYb �PECUU_ INSPECTOI REQUIRED 0 YES REMARKS OC UPANT GROUP RECVD VAWATION $ Description FEE Description e8CrPt'O Din FEE Plan Check GLAZING % LOT SLOPE % Building PLAN CHECK NO: VESTED DATE Plumbing Mechanical NIEE MB PERMff AUTHORGOES ONLY TH2, WORK NCrHE0- THIS PEmRT CMM WORK TO BE DOM ON PRIVATE pROpERm, ONaX ANY CONS-FRUICnON ON THE PUBLIC Grading Recording Fee DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. UC-) WILL 61 EOUIRE SEPIULATEPERMISst ON. Engr. Review City Surcharge PERMrrAPPL1CATIOH 160DA" PERMFIr UUM I YEAR - PROVIDED WORK HISTARMEDWITHIN ISODAYS Engr. Inspection State Surcharge SEE ELAM OF PINK PERMIT FOR MORE INFORMATION ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Deposit IN INTEREST AGREES TO INDEMNII DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS MOM ANYAND Fire Review Receipt III ALLCLAIMSFORDAJMAGESOFWHATEVER NATURJE.AFISINGDIRECTIYORINDIRECTLY MOM THE ISSUANCE OF THIS PERmm ISSUANCE OF THIS PERMIT SHALL. NOT BE Fire Inspection Total Amount Due DEEMED TO MODIFY. WAIVE OR REDUC_- MY REOUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CFTYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. Landscapainsp. Receipt # I HERE13Y AC101OWILEDGE THAT HAVE READ THIS APPUCATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT, M D THAT AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF � . w� ""` 11=1. THE OWNER. I AGREE 0 COMPLY WITH CITY AND STATE LAWS REGULATING CONSTAUC- CALL orsew .= =.Y NO THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED E OF A.HINGTO. RE-ING TO FOR INSPECTION 4 �Jh. Ix IN: THE . W. EA AND RCW 10,27. 0 SIONAT TE IATE IG END DATE SIGNED (425) 771-0220 ED By *TTENTION EXT4-33S— U LAWF To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL U 771-0221 1 IT VFI A L 'N.P EL.TION HAS BEEN MADE AND APPROVAL OR A CERTIFI. OSnIM_E YELLOW -INSPECT R GOLD ASSESSOR CATE OF OCCUPANCY HAS BEEN RANTED. UBC SECTION 109 G FAX - PINK - OWNER - x __/__ E� z IT! M C: M C) 0 8 0 C: -1 r i MM 1 4 . 10 C: C: 0 -n _n M M 0 0 0 Fn IT10 Z�7-1 (0 z 0 4 0 IT