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20010853.pdfCITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION iES NAMEMAMS OF BUSINESS Fh,l-o v �,L Z_ — ING ADDRESS Oi'l%� JAE rj PERMIT EXPIRES USE PERMIT ZONE NUMBER JOE , I T ADDRESS Jof /c( cj,/V/— FLAT NAMEISU601VISION NO LOT NO LIDNO I Lt. FEE PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP P EXISTING — PROPOSED— REOUIREP DEDICATION— FT — METER SIZE LINE SIZE NO. OF IIXTUFES P V PEOUSED I I YES 0 NO C3 REMARKS _LWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTR UDRAINAGE C:��6 V,�� ITELEPH04E xs g + NAME >rgo&Lim� ENGINEERING REVIEWEDIDATE ADDRESS FIRE REVIEWED BY DATE CITY CIV14 Op TTZ�E VAR;; ORCU SHORELINE OR ADII 00- bi f INSPE.CTION E . )s:(Y R ON. I P6 OND. STE STATE LICENSE NUMBER ATIO D E ED A ��WE' UP SIGN AREA ALLOW PRO _aa Z; HEIGHK , 0 C ALLOWED P 0 Cyo - - I Iq PR?E[j ACC.UNTPAR EL NO. cfOV 7 0 RESIDENTIAL 'NEW 0 PLUMBINGIMECH ADDITION o COMPLIANCEOR OMMERCIAL CHANGE OFUSE C3 REMODEL APARTMENT REPAIR GRADING CYCIS 0 FENCE X PT) I- - OTHIF FT' DEMOLISH TANK C] OTHER C] GAS GE 0 RETAKI�N�MQ WALL [3 RENEWAL Lj RENEWAL CARA POST ROD X4 LOT COVERAGE ALLOWED PROPOSED REOVIReD SETBACKS ' 111) FRONT, SIDE FEAR 0', ;T A;4PUNNING RE REVIEWED By DA R MARK ARKS a4-e- mo __- -& 5 40bi ALI,-, A-,A,,4 0 CTIVITY) EXPLAIN: F TY P. CHECKEDBY JTYF� H.CKE" �07XrTION IC G CCU V,10 F.UrT w' NUMBER MU, OF Pe OF ST, LIM BEIROF WELL NO NITS "TCAL 'EAS ..E F SFE.IALE�..SPIECT.R JAREA SPECIAL E FE.0 E R U F YES OIGUPANT LOAD _J�N DESCRIBE WORK TO BE DONE REMARKS !ROGRESS INSPECjIopVyaLtB0.198/FI9kL INSPECTION RED' P fj Z V1115W(4 410 0744 L&A IV M. I p _S7 w 9 e 6 VALUATION FEE PLAIN CHECK FEE HEA�� T 'Lo BUILDING 12 r7l, PLAN CHE -7 IVESTED �OAIE E ME HANI-AL MECHANICAL .TC V ORKTO THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS W t: BE DONE ON PRIVATE PROPERTY ONLY. AN' CONSTRUCTION ON THE PUBLIC IJB _2 DOMAIN (CURDS. SIDEWALKS, DRIVEWAYS. MARQUESS, ETC.) WILL REQUIRE SEPARATE PERMISSION. GRADINGIFILL PERMIT APPLICATION: uO DAYS PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WIT.1 N 18G DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION — ENG. REVIEW FEES ENG. INSPECTION FEE 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND suCCESORS IN NTEREST. AGREES TO INDEMNIFY. DEFEND AMD HOLD HARMLESS THE CITY OF P` I 2 EDMONDS, WASHINGTON, ITSOFFICIALS EMPLOYEES. AND AGENTS'RoM ANYAND M A LCLAIMS FOR DAMAGESOF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY I H L oT R A L N I FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY. WAIVE OR REDUCE ANY PEOUIREMENT OF ANY CITY ORDINANCE NOR LIM IT IN ANY WAY THE CITY 'S ABILITY TO ENFORCE ANY ORDINANCE PROW VON. - LANDSCAPING INS�ECTIGVFEE PLAN CHECK DEPOSIT TOTAL AMOUNT DUE 15E t HEREB ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION AGENT OF S CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF GIVEN I R U oNSTRUC Y UTHo:R'Z� Y G THEOWNER. I AGREE 70 COMPLY WITH CITY AND STAI E LAWS REGULATING CONSTRUC. C ON W, P TION.ANDIN DING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED 'AT,NG TO IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASH11GTON RELAT, T WORKMEN S COMPENSATION INSURANCE AND RCW 18.27 CALL FOR INSPECTION APPLICATION APPROVAL 8.,t Th., ppI,P, po-1 10 Pghed by the d.hQ Ofl,1111 P, h�,A,11 DoPuhy: and Feel — Fed. hel d,h.p— Provided, receipt is acknowtodg0c SIGNATURE DATE (425) 771-0220 &OFCIALS. Nil 1A ou, adLa _P, OAJ slt� DATE SIG�ED A17ENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 dSPECT& A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - I SPECT4R CATE OF OCCUPANCY HAS BEEN GRANTED. LIBC SECTION 109 FAX PINK - OWNER - GOLD - ASSESSOR 5M. z 0 am a mo 0 -10 OC m w. 10 c 0 m M 0 vi o Fn c (A M 0 z z 9 0 m FINAL PROJECT APPROVACORM TO: DATE:_d_7_/_,9_Z MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE — ENGINEERING DIVISION DATE- - PLANNING DIVISION DATEALA�aZ_—_— PROJECT— SITE ADDRESS pF C ,RMIT # �2 00 1-6>8-573 ADB#_____PATF INSPE SPECTED_,4ZJ_ _5_161P�S DESCRIPTION OF WORK TO BE IN A field inspection was conducted to determine rwal compliance with approved plans. Final approval denotes that there are no objections from the above signed Department to the release of pERFO tMANCE BONDS and the granting of: --GRANT FINAL PROJECT APPROVAL GRANT PROJECT APPROVAL WYIH CONDITIONS NOTED o Copy of CONDITIONS given to owner/contractor by inspector 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 Date__. Sign_ ocaprv1.doc.1;tW:b1dg:forrw10/01 MICROFILM z 0 i 0 C: M rn 0 __10 00 C: --i M rn rn z jo -4 C 0 _n n --i M M 0 0 0 C M, 9 U) M 0 X --i M z --I M z 0 4 0 M RECORD OF INSPECTIONS m (A ofn rn z 0 M MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. - lol I I N I N,,!: I PERMIT EXPIRES CITY OF EDMONDS PERMIT NUMBER CONSTRUCTION PERMIT APPLICATION joB YEJAPTI ADDRESS I ERNAME�AME OF BU FINE iL PLAT NAME/SUBOIVISICN NO. LOT NO. LIDNO. LID FEE $ "loADDBEss 01 Iq PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED — ZIP TELEPlbNE _&Il REQUIRED DEDICATION_ FT METE' SIZE LIIESI�� N..CIIDXTURI� p V REQUIRED A ect I; 4-0-t� I —YES 0 NO REMARKS OWNESJCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAI�AGE BESS 66CT-e x IV. ZIP I vv,4 TELEPHONE D_os-an-474 AAlAfqM [Al ENGINEERING qww sea v AtFIRE REVIEWED BY DATE TELEPHONE VAFIA�C VARIANCE OR �'q V 00-6 SHORELINE OR ADB# 412F-.00-M INS.PEE.CTION D )KYES ON- ATE STATE L CINIE NUM81R E !wm15's:l:llo 3`6 0 KE. 1 PAR C� 'LET, EXP SIGN AREA ALLOW PROPOSED In 1,1=0 HEIGH ALLOWED PROAC)ED I ACCOUNT 11 CEL NO. PRrfjjA_ Ova - 61007 PLUMS NGIIVE N C3 RESIDENTIAL PLUMBING/MECH AUDITION --ERCIAL o COMPLIANCE OR _�O CHANGE OF USE 0 REMODEL PARTMCNT SIGN REPAIR G T) 0 0 E] PAIINI CYUS 0 x 0 TH 0 DEMOLISH C] TANX 0 C] GARAG�E' E RB. C] RETAINING WALL 0 BEN WA CAR LOT COVERAGE ALLOWED ALLOWED PROPOSED 1,19FAPP14AM, REQUIRI!D SETBACKS U`T) `Ro�NTI SIDE EAR I S -19- PROPOS LIP SIDE REAR r //,f PARKING AREA REDD PROVIDED PI-ANNINGREVIEWEDBY DATE 12 e�v V- gl Nef �144f�4 (�PEOFUSE.BUSI ESSOR CTIVITY)—IN: 9SsoR cHECKEDBY ITY T�JCTION '07 1 MuB I NUMBER NUMBEROF CAL s 11MAL A OF DW LUNG AREA STORIES UNIE R TS NUMBE _LR DESCR16E WORK TO BE DONE I/VT41L t4u.jl_ YVST Al 1, PLAN CHEC F THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO E. ��..P.�—EPR.PERTYO�-A.YCON�T�.-I.�..T.�PU... 0 U OMAIN (CURBS. SIDEWALKS, DRIVE AYS. MARQUEES, ETC.) WILL RED IRE SEPARATE PERMISSIONI RMIT APPLICATION: 180 DAIS PERMIT LIMIT, I YEAPE ' PROVIDED WORK IS STARTED WITHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION SIGNS AND SUCCESORS -APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. AS I N INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMIE SS THE CITY 01 2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FRO. ANY AND DIRECTLY OR INDIRECTLY ALLCLIIMS FOR DAMAGES OF WHATEVER NATURE.ARISING X FR A THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE C DEOEMED TO MODIFY, WAIVE OF REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE o ORDINANCE PROVISION. X NOR LIMIT INANYWAYTHE CITY SABILITYTO ENFORCE ANY PECIALINSPECIOR JAPEA REQUIRED 0 YES occ, LOAD PANT REMARKS ECTION RECI'D 'E PROGRESS 1NSPECJI 'g 8/FIfL INSP mw VALUATION FEE LAN BUILDING LOHICKLFEI PLUMBING MECHANICAL GRADINGIFILL .@�SURCHAFGE ENG. REVIEW FEES ENG. INSPECTION FEE LANOSCI;;Il INSPECT PLAN CHECK DEPOSI I TOTAL AMOUNT DUE SE.BY INEREBY ACKNOWLEDGE THAT I HAVE READTHIS APPLICATION. THAT THE INFORMATION GIVEN IS CORRECT, ANDTHAT I AM T.EOWNER.OATHE DULY AUTHORIZED AGENT 01 THEOWNER IAGREETOC Y WITH CITY AND STATE LAWS REGULATING CONSTRLC O-PL ED TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NOPERSON WILLBE L"'LOY IN VIOLATION OF THE LA80R CODE OF THE STATE Or WASHINGTON RE ATMG TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18,27. CALL FOR INSPECTION (425) APPLI ATION APPROVAL Y, El.NAT...0 DATE aujjLJ2�& DATE IIG�ED 1 771-0220 ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 17 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL � FILE YELLOW - 114SPECT H CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSE—H "SS z 9 0 m Im m 00 A mz C) c cn 0 _n -n m m 0_0 0 0 Fn C (a C U) M 0 cn z 0 d 0 m