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20010933.pdfDATE RECEIVED ��' p� 1) PERMIT EXPIRES IL US USE PCITY ZONE 5 / 12 NUMBE OF EDMONDS CONSTRUCTION PERMIT APPLICATION JOB SUNEIAPTA ADDRESS 1?210 /1, /A Xua, C� Ci OWNER NAMENIAME OF eU61NE65UBOM// LV PIA, NAMEISUeOMS10N NO. LOT N0. 110 NO. S�. L t I N 0+--�, • 1 (�i3 7 UD FEE S g 111ING ADDRESS gWparm°°n p°1O�0puM�e ` // T 0 1 2 I O 1 NA (C V 1 Q, W +" r PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING PROPOSED — CITY 21P TELEPHONE O G n I L(� �Q - REQUIRED orET DNDS IAO'.LO l (s M0� METER SIZE LINE SIZE N0. OF FIXTURES PRV REQUIRED NAM,p� IL <I N 6 � E- I N S VES ❑ NO ❑ �WW C ADDRESS REMARKS OWNEIVCONTRACTOR RESPONSIBLE FOR EROSION CONTR04CMINAGE u� ,Gi 4 �� CITY ZIP TELEPHONE L nnur0 0� 18 03-1 NAME �D .�J��/��'y �"Lir� C///w_!51- &ff j� ENGINEERING REVIEWED/DATE ADDRESS �i> 'L/ DATE (J /� FIRE REVIEWED By C/ITy�y� ZIPJJ� TEIEPLO�NE� ON BON r` VARIANCE OR CU SHORELINE OR ADS! INSPECTION NSgEo STATE EXPIRATION GATE CHECKED BY �YEB �J NO /UCE)kS—E}NUMBER / {a 0/A N SEPA REVIEW SIGN AREA HEIGHT COMPLETE EX{/EMPT ALLOWED PROPOSED ALLOWED PROPOSED - PROPERTY TAX ACCOUNT PARCH NO. Q Ol3 ... 010 EXP �LI. ZJI LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.) RE610ENTIAL M£CH ALLOWED FRONT SIDE FRONT UR SI Err'_RlT, o ❑ NEW R pWMBING pnOpOSED ^RW 15�r I�1 .^Y fjl �Df aI1 IV �T�t Z ADDITION COMMERCW- COMPLIANCE OR ��0 ❑ ❑ CHANGE OF USE PARKIN" LOT AREA PIANNINOQREVIEWED BY D E ❑ REMODEL ❑ APARTMENT ❑ SIGN REc0�0 FR021DEp flll� Q� IZ/yl d GRADING ❑ FENCE ❑ REPAIR ❑ CVD9 X Fr) REMARKB ❑ DEMOLISH ❑ TANK ❑ OTHER WALLY ❑ RENEWAL ❑ CARPORT ❑ ROCKER" C (TYPE OF USE, BUSINESS OR ACTNEXPEXPLAIN:C RY) CHECKED RY TYPE OF CONS UCT10N CODE OCCUPANjr___ 3 GROUP 1 �7 � NUMBER NUMBER OF CRITICAL SPECUL INSPECTOR AREA OCCUPANT DWELLING AREAS A LOAD OF REQUIRED STORIES UNn'9 NUMBER I/ ❑ ,fig _� / DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 10a/PINAL INSPECTION REO'O uu S 9 1 — VALUATION $ 3 Deacrl tloR Descriptlon FEE ��FEE Plan Check ,�(7 M U OUZIN % LOT SLOPE % Building IK / i PLAN CHECK NO� —7� vESTEO DATE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading Recording Fee j DOMAIN (CURES, SIDEWALKS. DRIVEWAYS MARQUEES, ETC.) Mu. REQUIRE t SPPARATEPERMISSION. Engr. ReVIaW City Surcharge a DAYS /Q $ PERSISTAPPLICATION:WORK TSTARTE Stale Surchaf a y,✓ � PEAYR UMm 10D DAYS Engr. Inspection 9 - p1m pgAAWORK M REINFOWRHiN BEE SACK OF PINK PEgMR FOR MORE INFORMATION ACK O Plan Chk Deposit Traffic Mitigation - 'APPLICANT, ON BEIULF OF HIS NI H. D SPOUSE, HEIRS, ASSIGNS AND HE CITY OF _ AGREES INDEMNIFY; DEFEND AND 110LD HARMLESS THE CITY OF Receipt p 7 IN INTEREST, WASHINOTON, RS OFFlCIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire RBYIBW N. EDMONDS, ALL CWMS FOR "AMA"ES OF WHATEVER NATUAE.ARSINGOIRECTLY OR INDIRECTLY TDtalAmount Dua OF THIS PERMIT SHALL NOT BE FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE Fire Inspection WANE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINANCE 9 DEEMED TO MODIFY. i NOR LIMIT W ANY WAY THE CrTvS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' LandSCapB Insp. ROCDIpI A' I HEAEBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN B CORRECT; AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF Tnia epplicelion la not epermit anal alpnee I V 11 THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL B°Ileinp OffNel or nHmer Gapery. end Fees ere polo, en0 TOM; AND IN DOING THE WORK AUTHORIZED TNEflE6l. NO PERSON WILL BE EMPLOY FOR INSPECTION ecoipiHeckno,Neepetl Nepeca prwleetl. OF WI.SHINGTON RELATING TO r IN VIOLATION OF THE LABOR CODE OF THE STATE WORIOLENS YPENSATION INSURANCE AND RCW 18.27. OFFI ALS AT DATE A^C AT 61GNAN ( i OR NTj DE SIGNED (425) �9y I 2-1 O' I / 1 —0220 RE ED BY ATE ATfElii BIN 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- oRIGINA-FILe veunwl SPELT R r / CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK OWNER GOLD -ASSESSOR 1Wo, Z m CM m� �O On C A r. m 1 Dz 1 IT ITT oN m fin In �r to Z 4 n m .- .- ---- -- .... \�.. ..... �I�jonl ...�q fi'6�9� t�►1tAr} ,�•' �� c�;}0�{, gip. -U�,�- \ � 19p, rlA AAI?S �lLlkdd�t7 Ub®i - ' r \ � Aka- -loaulajs Atnh �s n� r2 ib-25 #AA* `lw RECEIVED DES I a 7-; CITY COPY DEVELOPMENT CTR CITY OF EDMONDS . TOTAL P.02 o•i� � T I i ma o� M m aZ n 1 o' I m m RECORD OF INSPECTIONS I'< INSPECTOR DATE APPROVED II - ... ... ,. SETBACKS ..................... i Cj. :, .. ...._ " FOUNDATION: - i. - " Footing I d wan.......................... - - -Pier/Porch ................. • 2l O 1 � - Wall Retalning ........... m Slab Insulation ......... .. " ,•. ", .,x; • PLUMBING: - `, m' +. Underground _ Rough -In................... Final...... Oc Commercial .. .. HEATING: m Gas Test.. ......... _..... - Gas Piping ... ...... .... �. - 7 ... ... -.._, Equipment ... .. ,.. T �• ,. ' Commercial Final ..,.... :.. •.... m m .. EXTERIOR SHEATHING. - ,..:: pp Ol: Or ^. . _..._.:. .. —NAILING .... ......:... ... FRAMING ........................ m O (. FIRST FLOOR FRAMING... 15, ,. - .. INSULATION ................... ,, .. .. .. ;. Floor Insulation ......... - - •- .. Wail Insulation ........... - - Ceiling Insulation ....... �� - a. ' - SHEETROCK NAILING .... m SPECIAL INSPECTION ... MISCELLANEOUS .......... - FINAL APPROVAL FOR I ' - OCCUPANCY ti I I I DATE RECElv6o /qd _ // - PERMIT EXPIRES j CITY OF EDMONDS ZONE /' J /'2 PERMIT L- NUMBS � CONSTRUCTION PERMIT APPLICATION 'DG SURE APTP AODRESB %7�/�} j %`JME- OWNER NAMENAME OF BUSINESS _ -• 1 .,11h11 L I I,S ✓�L/ tE1SUDDM9ION NO. LOT N0. i LID NO. UD FEE P ! YANG All IS°^°-] TIGHT V OF WAY PER OFFICIAL STREET MAP qly pmul p2 l -.• ;.; n) I [ 1 l' L'J i-AwD•Rpi'.EC -PROPOSED yba•aAp•VtraE ZIP TELEPHONE Tli`Jao IA Jl./LD L->,/, DEDICATION FT Wmipu`w G,vp', LINE SIZE NO. OF F"TF(ES 11DflESB ITRE E:ii-, I �. 11 11`/ l:. 1J � , G IVl \_ YES O NOVREQUIREO DRESS(/ i ONTRACTOR RESPONSIBLE FOR EROSIDN CONTROUDRMNAOE 7-7 j} W E C11Y L F ZIP TELEPHONE ��=13-i nllw000l ( ,j NAME `y/ 7 �, L L (P ENGINEERING - REVIEWEOIDATE .l v/ I /(/ FIRE REVIEWED BY DATE Clry ZIP TELEPHONE BOND VARIANCE OR CU SHORELINE OR AOBI INBn ON y P09TE0 7T 7 eTATE LICENSE NUMBER EXPIRATION DATE CHECKED BY hI �A , • ,� N El l7 YES 'QINO 1 /-yy��/� y/ Q G / �� SIDN AREA HEIGHT O�CY �7`• /�� 9EPA REVIEW COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED F OPEW/TAX ACCOUNT PAi10EL NO. } - of -_)!) EXP X N A fig' 2T1.5l j ECH LOT COVERAGE REQUIRED ALLOWED BED SETBACKS (FT.) FRONT S1DE BEAR PROPOSED SETBACKS (FTI - FRONT UR 61 E R114{ z i ❑ NEy( RESIDENTIAL PWMBINO COMPLIANCE ORG51 PROFrPE 1 �1 '�a, all lrj 1p I �ADDRION ❑ COMMERCIAL ❑ CHANGE OF USE PLANNING REVIEWED BY DATE ❑ REMODEL APARTMENT ❑ ❑ SIGN PARKING 1.0T AREA RE D PROVIDED FENCE ❑ REPAIR ❑ GRADING C., ❑ FT) REMARKS P ❑ DEMOLISH ❑ TANK ❑ OTHER q j- S . GARAGE RO WALL ❑ RENEWAL ". ❑ CARPORT ❑ ROCKERY A • y.. _ . CHECKED BY TYPI SPECIAL INSPECTOF REQUIRED n YES TO BE VALUATION $ J'? i Descrl tlon FEE Descrlp9lon Plan Check H B GL111N % LOT SLOPE % i/ Building CY •l VE9TE0 DATE PLANCHECKNO� Plumbing Mechanical )• (liV (�FiS iNt0 PEP11R, AIRHORr ONLY iHEWORKNOTEO. THIS PERIIR COVERS WORK TO BECCNE ON PLANATE PP.OPFJTIYONLC ANY CONSTRIlCf10N ONTNE PUBLIC Grading g _ Recording Fee ppyAiA L.0 7SIOEYVALKB,DRIVEWAYS, MARDUEM, ETC.) WILL REQUIRE I SEPINATEpLIWISSION' Eng, Review City Surcharge �� n PERMRrAPPUCATION: INDAYS PERWTUMFC1 YEAH. PROVIDED WORK 16eTARTEDWRHIN IN DAYS. Engr. Inspection State Surcharge SEE BACK OF PINK PERMIT OR YORE INFORMATION Plan Chk Deposit 'APPLICANT ON BEHALF OF HIS OR HER SPOUSE. HEIR-. AB910NS ANO SUCCESOR9 Traffic Mitigation i IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD NARMlE89 THE CRY OF EOYONDB, WASHINQTON, Re OFFICALS, EMPLOYEES. Me AOFJITB FltOM ANY AND FITS RBYIBW Receipt # ALL CLAIMS FOR OAMAGES OFWHATEVEA NATUfiE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERM(D ISSUANCE OF THIS PERMIT SHALL NOT BE Fire Inspection Total Amount Due D -MID TO MODIFY, RE MAW HE CCRYS L NCR UMIN ANY WACE A91t1 TO ENFORCE ANY ORDINANCE PROVISION.*R YITHE Landscape lnsp. Receipt# I AND THAT I HAVE READ THB OR THE DIAL THAT THE INFORMATION t HEREBY ACKNOWLEDGECORRECT THE DULY AUTHORIZED AGENT OMEN Y CORflECf; AND THAT I AM THE OWNER, APPLICATION APF TNa Ap "KIo aw a pe,nM Ynl STATE EGU C- . THE OWNE0. I AGREE TO COMPLY WifH CRY AND STATE LAWS REGULATING CONSTIIUF T101 AND N DOOIG THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE TO TO CALL FOR INSPECTION aWdlnp OIf W w NHTx Oepury: m, recalpiHecanoMadpad-,spa i RELEMPATING IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING i V/ORKIIENB C PENSATION INSURANCE AND RCW 16.E7. OFFIC Tu OgNAN ( E-OHIAGEITI) OATM EIOI r ,- /✓! (426) I 771-0220 A A ED BY EXT 1333 � �` NTION IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 Wi FINAL INSPECTION NAS BEEN MADE AND APPROVAL OR A CERTIFI- SECTION 109 FAX CARFINAL- rEuc PINK -OWNER • GOLD DATE OF OCCUPANCY HAS BEEN GRANTED. UBC t 1 _ IDy INe F paid, Mid lad. DATE ATE i PEOT R 3500 `X\/ I